Retreat Registration Form | Calm Heart Yoga

Quiet Reset April 2025
Retreat Registration Form

First name

Last name

Phone

Birthday

How did you hear about Calm Heart Yoga?

Yes, subscribe me to your newsletter.

Please describe your past yoga experience and present practice

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.)

Special Dietary Considerations

Emergency Contact Name

Emergency Contact Phone

I hereby state that the information I have provided in this booking application is true and correct

I have read and accept the Terms & Conditions on the Retreat Brochure

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

Quiet Reset April 2025 Retreat Registration Form

Acknowledgement of Country

Quiet Reset April 2025
Retreat Registration Form