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 would like to register for Restorative Yoga Nidra Method and Mindfulness training course for Health Care Practitioners - 8 Modules

Live Online Starts Feb 23, March 2, 9, 16, 23, 30, April 20, 27 (8 weeks) Tues 6pm – 8.15 pm AEST = GMT +10 (or replay if you miss a class)

Can't make the live session times but choose self-directed learning via the portal with recordings of the live session. Includes access to Q & A sessions and an alternative assessment.

2021 Starts Feb 23.

Do you have Yoga or Meditation/ Mindfulness experience?

Yes

Type of yoga, meditation, mindfulness experience

Do you practice meditation on a regular basis?

Yes

Are you a Health Therapist? For Allied Health Practitioners; What is your qualification eg Physio, Occupational Therapist, Psychologist, nurse 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 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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