Do you practice yoga, if so how often? *

Please tick how long and the type of yoga you have mainly practiced.

No, new to yoga

Occassionally

Once per week

More than once per week

Hatha

Satyananda

Ashtanga

Vinyasa

Other

Do you practice pranayama and meditation regularly? *

If so, tick the practice/s you do regularly.

No

Pranayama (breathing techniques)

Meditation

Yoga Nidra

I prefer asanas (postures) that are

Please tick your preference:

1 Gentle

2

3

4

5 Dynamic

I’m interested in learning pranayama (breathing techniques) *

Please tick your level of interest:

1 Extremely Interested

2

3

4

5 Not interested

I am interested learning meditation *

Please tick your level of interest:

1 Extremely Interested

2

3

4

5 Not interested

I find meditation difficult *

Please tick how you find meditation:

1 Easy

2

3

4

5 Difficult

I enjoy Yoga Nidra (deep relaxation) *

Please tick your level of interest:

1 Extremely Interested

2

3

4

5 Not interested

Do you have any health conditions? *

High blood pressure, if so what was your last reading? Enter below.

Low blood pressure

Heart conditions

Back conditions (Sciatica, scoliosis etc)

Osteoarthritis, where?

Neck conditions

Knee ligament damage or strain

Pregnancy, how many weeks?

Stress

Depression or Anxiety

Other, please advise below

No health issues to advise

I understand and agree: *

In any physical activity, risk of serious physical injury is possible. Yoga is no substitute for medical diagnosis and treatment. Yoga practices and / or specific poses are not recommended for individuals with certain conditions (e.g. Cardiac illness, later stages of pregnancy, post surgery). The student assumes the risk of yoga practice and releases the yoga teacher from any liability claims.

I am participating in yoga and meditation with Yoga for the Soul Retreats. I am aware of the physical risks involved with any form of exercise and understand it is my personal responsibility to consult with my doctor regarding my participation. I have no medical condition, which would prevent me from taking part in practicing yoga/meditation, and assume responsibility for any risk or injury I may sustain as a result of my participation. I have read the above and understand it's contents. I agree to the terms and conditions stated above.

Would you like to go on a Yoga Retreat in: *

Tick which destinations interests you.

Australia

Bali

India

Nepal

Not interested thank you

Name

First Name

Last Name