65 Hr Women's Yoga & Leadership Teacher Training Registration Form
Dates: 1st - 10th October 2022
Venue: Ericeira, Portugal
Contact us at atira@atiratan.com. www.atiratan.com

All answers are strictly confidential and will not be shared with anyone else.
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Email *
 First/ Last Name *
Phone Number *
Address
Country
Date of Birth *
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Gender *
Emergency Contact Name & Phone.
Skype Username
Facebook Profile
This is optional but a good way for us to share group information so highly recommended
What style(s) of Yoga do you practice regularly?
Are you a yoga teacher?
Clear selection
If you're an active yoga teacher, what classes do you teach and what kind of community do you serve?
Clear selection
How long is your daily practice (in hours)?
If you meditate, how long have you been meditating, and how often do you meditate?
Approximately what year did you start to practice and/or teach Yoga?
Please provide the names of your principal teachers or schools.
Do you suffer from any medical condition? Are you taking any medications?
If you are under medical treatment or supervision, please tell us about it as thoroughly as you can.
If you have any chronic physical impairment (e.g., vision, hearing, movement, etc.), what is the nature and extent of your health challenges?
If you have had a recent history of fatigue, emotional collapse, or major trauma please tell us about your experience and where you are in your recovery.
If you are using any prescription medication, please indicate type, dosage, and frequency of intake.
Are you currently experiencing any injuries?
List all that you think are relevant including chronic and acute.
Is this your first time to Ibiza?
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How did you hear about this Yoga Teacher Training?
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What is your main interest in taking this Women's Yoga & Leadership Training?
Dietary restrictions *
Are you applying for a shared or single accommodation? *
I have read and understood our Yoga Teacher Training terms and conditions, and will be fully responsible for you are responsible for your own health and wellbeing during the yoga teacher training. Swara Yoga School will not be held liable for any injuries or other medical or mental health problems that may occur, are sustained or aggravated during or after your time on this training. I understand and our cancellation and refund policies which can be found on our website and agree to our Terms and Policies. *
Required
By applying to this training program you agree to comply with these terms. Your signature below acknowledges your agreement with this policy. *
Thank you so much for filling out this registration form! We look forward to journeying with you.
With Love, Atira & Sofia
A copy of your responses will be emailed to the address you provided.
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