Which Immersion/Training are you registering for?
First Name
Last Name
Email
Address
City
State
-- Select -- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Non-USA
Mobile Phone
Home Phone
Date of Birth
Emergency Contact
Name
Phone
Your Health
Do you have any physical injuries or medical conditions?
yes no
If yes, please describe.
Are you taking any medications?
yes no
Yoga History & Experience
How long have you been practicing hatha yoga ?
-- select -- less than one year one-two years two-three years more than three years
How long have you been practicing Anusara Yoga ?
-- select -- less than one year one-two years two-three years more than three years
What is your level of understanding of Anusara's Unviersal Principles of Alignment ?
-- select -- beginner intermediate expert
Please describe your personal practice:
Why do you practice Yoga?
Why do you want to take this particular training?
Please list any and all immersions, workshops, trainings and classes you have participated in with Certified Anusara Teachers.
Do you currently teach yoga?
yes no
If so, what style and for how many years?
What else do you bring to your training?
Is there anything else you would like us to know?
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