HeartSong Enrolment Form
Are you coming to HeartSong? Hurray!! What now?

1)  If you haven't already, register via the website and make your payment.
2)  Fill in and submit the enrolment form. Red asterisk = required field.
3)  Do a little dance! (this bit's optional!)

Name *
Email *
Address *
Phone number
Emergency contact details *
Please provide the name of a relative or friend who we can contact in case of an emergency
Emergency phone number *
Take a moment to contemplate.... What are you intentions for the weekend? What called you to book and what do you hope to gain from the weekend? *
Have you practiced yoga before? *
If yes, which system/school?
Yoga classes will be gentle and anyone will be able to join in. Tell us a bit about YOU.... Describe your body: health conditions, problem areas, injuries, illnesses, spinal problems, if you're pregnant or anything else you'd like the teacher to know.... *
Dietary / Health / Mobility Requirements
All meals will be vegetarian. Please indicate if there are any dietary, health or mobility issues we may need to know about or ask any questions here.
Please elaborate any dietary requirements or specific allergies here (if required):
Are you a heavy snorer or do you have sleep apnea? Do you use a CPAP machine? Light (cute?) snoring isn't usually an issue - this question is for those with a grand symphony of evening song! (Where possible we will accomodate heavy snorers in the same room...)
Any additional notes re sleeping habits?
Shared rooms means we can't always get a quiet room for you, but if you're a super light sleeper let us know here, and we'll do our best to find you a quiet spot.
Do you have a friend or group of friends you'd like to bunk with?
Will you bring your own van to sleep in?  (FYI Van parking is in the car park and it's a little bright for security.... bring curtains!)
If you have any mobility issues we need to know about, please elaborate here:
Would you like an optional Zenthai Shiatsu treatment with a qualified therapist over the weekend? Cost will be $90/100 for an hour depending on the therapist and you pay them directly - cash is a good idea in case reception is patchy!
How did you hear about HeartSong? (you can check more than one answer!) *
Required
Terms and Conditions
By submitting this form, you agree to our Terms and Conditions, to take responsibility for your wellbeing and communicate any difficulties or issues with the facilitators. *
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