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Student Registration Form

Kindly fill in the form below, and "sign" the Teacher Indemnity Statement before you attend the first class session with me.

Name

First Name

Last Name

Gender

Female

Male

Date of Birth:

YYYY

Address

Email Address

Mobile No.

Singapore Numbers only

Please share your yoga practice background: how long, which teachers, and which school of yoga practice.

This helps the teacher understand your responses to instructions and how you may have a different understanding of an asana.

Please list all the health issues you may have, including any surgery or major treatment you have had in the past. The information requested below is to help the teacher ensure that you do not get injured or you do not aggrevate any health issue you may have. It also enables the teacher to determine which asanas will be helpful, or be proscribed for your situation. It also helps the teacher understand when and which props will help you do the asana correctly.

Confidential: for the teacher only. Ladies, pl. indicate if you are expecting.

Teacher Indemnity

I have read the Teacher Indemnity declaration, and I confirm acceptance.