Private Yoga Registration Form

top of page

Home
About
- Testimonials
Yoga
Workshops & Retreats
- Retreat Registration Form
- Quiet Reset Retreat 2025 Brochure
Gift Card
Timetable & Pricing
Book Online
Contact Us
More

Use tab to navigate through the menu items.

Private Yoga Registration Form

First name*

Last name*

Email*

Phone*

Birthday*

I would like to receive news from Calm Heart Yoga

Emergency Contact Name*

Emergency Contact Phone*

What is the main reason for requesting private yoga? Please check all that apply.*

I am a beginner

I would like to deepen my practice and learn advanced poses

I would like a personalised yoga practice or plan

To address an ailment or injury

Other (please specify)

What would you like to get from your yoga practice? (Check all that apply)*

Muscle Strength

Joint Stability

Improve Posture

Flexibility

Improve Sleep/Decrease Anxiety

Spiritual Growth

Healthier Lifestyle

Increase Awareness

Improve Mindfulness

Improve Breathing

Reduce Stress/Increase Peace of Mind

Other

What yoga props do you currently have?*

Mat

Block/s

Bolster

Blanket

Strap

Other

Have you practiced yoga before?*

Yes

Please describe your yoga experience and current yoga practice?*

Yoga Interests*

Asana (physical practice)

Pranayama (breath work)

Dhyana (meditation)

Mudra (hand gestures)

Mantra (sacred sounds or words)

What do you hope to gain from private yoga sessions?*

What would you like to work on in our session/s?*

Please list any relevant injuries, ilnesses or health conditions? (e.g. asthma, high/low blood pressure, insomnia, heart, lung, back or neck problems, thyroid conditions etc.)*

If you require a personalised yoga practice or plan, please specify: a) what you would like to achieve from your plan, b) how long you would like the practice e.g. 30/60 mins, c) how often you are able to practice p/week?

I understand that it is my responsibility to inform my teacher of any relevant changes to my health and assume full responsibility for any physical injury or damages that might occur as a result of participating in yoga classes & workshops at Calm Heart Yoga.

Signature*

STAY CONNECTED

Subscribe for studio news, workshops and more

Acknowledgement of Country

Calm Heart Yoga respectfully acknowledges the traditional owners, the Bunurong people, as the custodians of this land. We pay respect to all Aboriginal community Elders, past and present, who have resided in the area and have been an integral part of the history of the region.

Calm Heart Yoga

Frankston South VIC 3199

Australia

bottom of page