Name

First Name

Last Name

Date

YYYY

Website

http://

Phone Number

(###)

###

####

Emergency Contact

First Name

Last Name

Emergency Contact Phone Number

Country

(###)

###

####

Yoga Teacher Certification / Date Completed

Tell me what style of Yoga you've studied, with whom and when you completed your trainings. Please send a copy of one certification for 200 hours YTT or more (only 1 is required - no need to send more)

Why are you interested in taking this course?

Please explain your reason for completing this training:

Do you have any injuries or health concerns?

Are you in good physical health? Please let me know about health issues or injuries that require attention.

Do you currently have a personal yoga practice?

Please describe:

Do you currently teach yoga (not necessary) ?

How many classes do you currently teach and to whom?

To whom do you wish or intend to teach aerial yoga?

Is there anything else YOU would like me to know to better serve you during this training?