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Class (required)

Class Date (if applicable) (YYYY-MM-DD)

Name(required)

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Telephone number

Message (Optional)

Payments can be made through bank transfer or PayPal.

Account name: ND DRAGANOVA

Account No: 33227790
Sort Code: 20-84-17
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For prices click here.

New Student Registration Form

Please fill in before your first session.

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Name(required)

Email(required)

Age(required)

Occupation

Emergency contact (required)

Referred by (required)

Client referral/Friend Search engine Advert Other

What is your current level of yoga practice?(required)

Newbie Beginner Intermediate Advanced Not sure

How often do you practice yoga?(required)

Daily A few times a week A few times a month A few times in the year N/A

What styles of yoga do you normally practice?(required)

Ashtanga Hatha / Gentle Vinyasa Restorative Yin Iyengar Power Bikram / Hot Kundalini Other N/A

What do you want to achieve from yoga classes?(required)

Strength training Flexibility Balance Stress relief Improve fitness Weight management Enhance well-being Injury rehabilitation Address health concern Alternative therapy Other

What aspect of yoga most interest you?(required)

Asana (Physical postures) Pranayama (Breath-work) Relaxation Meditation Yoga philosophy Chanting & Healing All of the above

What is your current level of fitness? (required)

Very inactive Fairly inactive Average Fairly active Very active

On a scale of 1-10, (1 is lowest, 10 is highest) how would you rate your level of stress?(required)

1 2 3 4 5 6 7 8 9 10

Please review this list and select the conditions that have affected your health either recently or in the past

Abdominal disorder or recent surgery Broken/dislocated bones Arthitis (osteo or rheumatoid) Back pain Hip problems Knee problems Shoulder or neck problems Diabetes 1 or 2 Pregnancy High blood pressure Low blood pressure Insomnia Anxiety / depression Muscle strain/ sprain Disk problems Scoliosis Asthma / short breath Cancer Heart disorders / chest pain Auto-immune condition Other

If you are pregnant, please confirm how many weeks

Have you created sufficient space and a safe environment for practicing yoga at home? (online classes only)(required)

I confirm that above information is correct. I understand that it is my responsibility to: 1. Check with my doctor if I have any difficulties or concerns about my ability to participate in a yoga class 2. Advise the yoga tutor of any change in my medical information 3. Follow the advise given by my doctor and/or yoga tutor(required)