Restorative Yoga Nidra Training Intake Form

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

Live Online Starts April (8 weeks) Tues 6pm – 8.15 pm AEST = GMT +10 (or replay)

Self-directed learning via the portal with recordings of the live session. Includes access to Q & A sessions and an alternative assessment.

2021 Starts April 20th 27, May 4, 11, (1 week break May 18) May 25, June 1, June 8, June 15th (8 weeks) Tues 6pm – 8.15 pm AEST = GMT +10 (or replay if you miss a class)

Do you have Yoga or Meditation/ Mindfulness experience?

Yes

Type of yoga, meditation, mindfulness experience

Do you practice meditation on a regular basis?

Yes

What is your qualification eg Physio, Occupational Therapist, Psychologist, Yoga Teacher etc

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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