YogAnga Retreat General Course Registration Form

I'm applying for the following course: *

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Name *

First

Last

Email *

Please enter your email, so we can follow up with you.

Birth Date *

Don't worry, however we require participants to be at least 18 years of age, we don't have age limits.

Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Tell us where you live.

Gender

male, female, trans, non-binary, etc.

Pronouns

he, she, they, etc. (so that we know how to refer to you)

Are you fluent in English? (check all that apply) *

Mother Tongue: *

What is the language you grew up speaking (know the best)?

Other Languages:

please list and describe ability

Please tell us about your sadhana (personal yoga / meditation practice)? *

Please describe your sadhana: *

Tell us more about your yoga / mediation / ritual practice.

Why do you want to take this course? What do you expect to get out of this course? *

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Anything else you would like to mention or questions you may have regarding our YogAnga Retreat programs?

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Is there any thing significant about your physical / mental health you would like us to be aware of, so that we can better assist?

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Where did you find out about this YogAnga Retreat program?

This helps us understand current and develop future marketing strategies.

Please describe if you mentioned "Other"

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I filled out everything on this form with truth to my best ability. *

Custom Captcha *

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