Thank you for taking a moment to tell me more about yourself! This form helps me prepare the best program for you and your yogic journey. I can’t wait to meet you! Name(required) Age(required) Email(required) Phone(required) Address (required) How did you learn about Elora Allen Yoga? Instagram Facebook My Website A friend / Referral Other Yoga Experience Have you ever practiced yoga before? (required) Yes No If yes, how often do you practice yoga? Daily Weekly Monthly What styles of yoga do you normally practice? Ashtanga Vinyasa Flow Hatha Bikram / Hot Power / Rocket Restorative Gentle How would you like to benefit from practicing Yoga?(required) Increase Flexibility Increase Strength & Stamina Stress Management Spiritual Development Find Body Love and Awareness Injury Rehabilitation Yogic Interests(required) Asana (poses) Pranayama (breath work) Meditation Yoga Philosophy Other What is your interest in learning meditation and breath work?(required) Reduce anxiety Realize my true nature & purpose Feel calm and centered Improve health Normalize blood pressure Lifestyle & Health What is your current level of fitness?(required) Very Active Fairly Active Average Fairly Inactive Very Inactive On a scale of 1-5, (1 is lowest, 5 is highest) how would you rate your level of stress? (required) 1 2 3 4 5 Please review this list and select those conditions that have affected your health either recently or in the past.(required) Broken / dislocated bones Diabetes 1 or 2 Pregnancy Muscle strain/sprain High/low blood pressure Arthritis bursitis Insomnia Seizures Disc problems Stroke Scoliosis Back Pain Asthma / shortness of breath Cancer Osteoporosis Heart condition / chest pain Numbness tingling Auto-immune condition (AIDS fibromyalgia chronic fatigue lupus etc) other N/A Please mention any medical conditions or limitations you have, and if necessary furnish a letter from your physician authorizing Yoga or stating any exercise limitations: Please read the following information and accept below. I am so excited to welcome you as a yoga student at Elora Allen Yoga. The following information will help you get the most out of your yoga classes and clarify the instructor/student relationship. I believe that Yoga is more than physical exercise. It is a transformative practice that integrates body, mind and spirit. This release of emotional tensions allows my students to arrive at deeper levels of relaxation and awareness. As with any physical activity there is a risk of injury associated with yoga. The decision to perform any exercise is down to the individual, and the instructor (Elora) cannot accept responsibility for problems during or outside a class. The participant agrees to take on full responsibility for their actions within the class and shall work within their own limits. If students have any inquiries or health concerns it is their responsibility to notify Elora so that she is aware of the students limits. If you are in doubt as to your fitness, please consult your physician beforehand. Elora shall not be held liable for any injury, loss or damage to property and/or persons sustained during or as a result of participation in this class. I agree to listen to my body and monitor myself during every class session. I agree to the Terms and Conditions as stipulated by Elora, including the cancellation policy. (required) I accept the statement I do not accept the statement Submit Share this:Click to share on Facebook (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Pinterest (Opens in new window)Like this:Like Loading...
