Registration Form – PhysioYoga & Wellbeing

Registration Form - Therapeutic Yoga Training Online

First Name

Surname

Preferred Name and pronoun.

Address

Apt, suite, etc.

Country

City

State

Zip code

Mobile Phone

Date of Birth

Emergency Contact

I am registering for Restorative Yoga Nidra Method and Mindfulness facilitator training course - 8 Modules

Self-directed learning via the portal.

This is an online course which can be taken in your own time. It is usually completed over 8 weeks but you can go faster or slower and take up to six months. You will have continuing access to the learning portal resources including research and recordings for 2 years.

Do you have Yoga or Meditation/ Mindfulness experience?

Yes

Type of yoga, meditation, mindfulness experience

Do you practice meditation on a regular basis?

Yes

Do you have a qualification in health, yoga or other? Please outline.

What are your areas of work/ career development?

What are your areas of special interest in this training?

Please explain if you have any physical conditions or serious mental health issues that we should be aware of.

I have read and agreed to the Terms and Conditions

Yes

Click here for Terms & Conditions

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