Registration Form

Personal Details

Name *

First

Last

Email *

Gender *

Male
Female
Other

Birth Date *

Nationality *

Phone *

What'sApp Number

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Choose Your Course

Choose Your Course *

Choose date when you want to Join *

Please Upload your portrait photo (for your diploma) *

Personal Health

Are you suffering previous or ongoing mental/emotional difficulties? *

No
Yes

If Yes, please specify mental/emotional difficultie *

Past or present trauma
Bipolar disorders
Depression

Are you suffering previous or ongoing Physical injury? *

No
Yes

If Yes, please specify previous or ongoing Physical injury *

Back issues
Surgery
Bone issues

Are you taking any prescription medication? *

No
Yes

If Yes, please share with us the prescriptions name & duration of usage *

Are you pregnant? *

No
Yes

Emergency Contact Person

Emergency Contact Person Name *

First

Last

Emergency Contact Person Phone

If other, please specify *

Comment or Message

Please check your details & affirm

I affirm that the information provided on this application form is true and complete to the best of my knowledge. False, incomplete, or misleading information is grounds for rejection of this application, expulsion from the program, or revocation of certification after completion of the program. *

Yes. I affirm

Please read our Terms and conditions page & affirm

I confirm that I have read on the Aranya Yoga rules, terms, conditions, privacy policy and cancellation policy *

Yes. I affirm

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Aranya Yoga Registration Form

We are looking forward to meet you. Namaste!

Personal Details

Choose Your Course

Personal Health

Emergency Contact Person

Please check your details & affirm

Please read our Terms and conditions page & affirm

Aranya Yoga

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