Application Form of vedic yoga center

Application Form

FOUR STEPS TO REGISTER

Personal Information

Select Your Program

Accommodation Reservation Request

Pay Your Deposit

Personal Information

All fields marked with a * are mandatory

* Choose Gender malefemale * Your email * Country *Specific requirements (if any)

* First name * Date Of Birth * Specific health disorders (if any)

* Surname * Phone no.(including country code)* * How did you learn about this program?

Emergency Contact

* Name

* Phone

* Relationship

Select Your Program

Yoga

Beginner Yoga Course

200 Hour Teacher Training

300 Hour Teacher Training

500 Hour Teacher Training

Master Level Yoga Course

Ayurveda

Panchakarma (De-tox)

De-Stress Program

Massage & Therapy Course

Cooking Course

Travel

Sacred Walk – Gangotri

Sacred Walk – Badrinath

Self-Retreat

I do not wish to enrol in a program. I am coming for a self-retreat

Accommodation Reservation

STANDARD ROOM * Arrival date:

DELUXE ROOM * Departure date:

Pay Your Deposit

PAY YOUR DEPOSIT NOW

First Name

Last Name

Specific health disorders (if any)

How did you learn about this program?

Country

Specific requirements (if any)

Date Of Birth

Choose Gender

Select Yoga Course

Ayurveda

Accommodation Reservation

Message

PAY YOUR DEPOSIT NOW