Registration Form

Name*

Age

Phone

Email*

Occupation *

Marital Status

Date of enrollment(dd/mm/yyyy)

How did you come to know about Dhrti?

Any previous yoga experience (If Yes, from where)?*

What are your goals/ intentions of joining the yoga session?

What time of the day you would like to practice yoga?

Any medical history or concerns (past / present / acute / chronic)?

Are you undergoing any treatment in any form (therapy or medicine) (Kindly don’t shy or hesitate to share your concerns as it’s important for instructors to understand your condition and preparedness for yoga and we assure you the confidentiality of your personal information. Concerns can by physical, emotional, mental, psychological - like Hypertension, Diabetes, Cardiovascular, Respiratory, Asthma, Neurological, Osteo and spinal, Arthritis, Eye, Menstruation concerns, Hospitalization etc - if any other, please mention, it helps us to take care of you better)

Please specify your habits, if any