BOOKINGS YOGA RETREAT REGISTRATION FORM First Name * Last Name * Date Of Birth Date of Retreat * Have you done yoga before? * YesNo If yes please specify style and duration High / Low Blood pressure * YesNo If yes, please specify Back/Shoulder/Neck/Knee problems * YesNo If yes, please specify Diabetes/Asthma * YesNo If yes, please specify Surgery please specify * Dietary requirements * Accommodation * Single roomDouble room sharingTwin room sharing Phone Email * Occupation Address The yoga teacher is not responsible for any injuries which may occur during the retreat.
