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Registration and Health Details

Registration & Health

To let me know about health issues and to register with Yinspire.

The information on this form is confidential to Yinspire

The information requested here may be more extensive than you are used to providing, however it is important for ensuring safety.

Please make sure you get the on screen confirmation after pressing submit - if you don't then I haven't received the form.

There is a save and continue option at the end of the page.

"*" indicates required fields

Name*
Email*
Address*
If you are retired, please enter retired and former occupation
Any previous yoga experience? If so please let me know the styles and how long ago.
Please let me know about anything which may effect your Yoga practice with me, or that you would like me to be aware of.
Health, physical limitations, worries, concerns, family stuff, things on your mind. Its all confidential.
Would you Iike a copy of this form emailed to you for your records?
Declaration
*
*
Important - when you submit the form, you should get an immediate success notification on screen and an email notification - if you don't see these, then the form hasn't gone through - check all the entries are completed properly.
This field is for validation purposes and should be left unchanged.