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Registration Form

Please take a moment to answer the following questions clearly and thoroughly. We want to know how to best support and nourish you during your program. Rest assured, all information you provide is kept confidential. If there is something you prefer to discuss privately, feel free to contact us directly.

Personal Informations

Emergency Contact

Experience & Intention

Yoga Experience
Have you practiced Kundalini Yoga before?

Health Information (Please answer honestly, your information is confidential)

Are you currently taking any medications? If Yes, explain
Do you have any physical limitations or injuries? If Yes, explain
Do you have a history of any of the following conditions? Required
Are you currently pregnant?
How would you describe your current level of physical activity?
Are there any other health-related information you would like to share with us? If Yes, explain

Thank you so much for helping us gather all the information we need to look after you in the best way we can.

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