Back To Wellness Iyengar yoga classes and retreats 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. Do you have high/low blood pressure? *---YesNo If yes, please specify. Do you any back, shoulder, neck or knee problems? *---YesNo If yes, please specify. Do you have diabetes/asthma? *---YesNo If yes, please specify. Have you had surgery? *---YesNo If yes, please specify. Dietary requirements * Accommodation---Single roomDouble room sharingTwin room sharing Phone Email * Occupation Address Send Message THE YOGA TEACHER IS NOT RESPONSIBLE FOR ANY INJURIES WHICH MAY OCCUR DURING THE RETREAT.
