Bhastrika Kriya Registration Form
Isha Hatha Yoga - Bhastrika Kriya

Saturday, December 21st 2019 - 12:30PM - 1:30PM

Location:
2065 Dundas St. E, Unit 103
Mississauga, L4X 2W1

Age: 14+

Program Fee: $80
Early Bird Fee: $60 (until 16th Dec.)

Contact:
Summit Lalwani
647-524-4553
therootsofyoga@gmail.com
www.therootsofyoga.com

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Please provide details of yoga or meditation you have practices and how long you have been practicing.
Have you learnt any other Isha Yoga practices? Yes/No. If Yes, please give details
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I hereby willingly undertake to attend this program completely. I take full responsibility for the result and indemnify the organizers against all claims and suits. I will not communicate the contents of the program, either directly or indirectly to anyone else. I understand the participation guidelines and agree to follow them. I hereby declare that the above information is true, accurate and complete to the best of my knowledge. (Electronic signature of your Full Name & Date is required in space below) *
A copy of your responses will be emailed to the address you provided.
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