4 week program registration - Vinod Dulal Yoga Institute

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Full Name

Date of Birth

Present Occupation / Designation

Nationality

Email Address

Phone Number

Address

Emergency Contact

Blood Group

Height in cms

Weight in kgs

Anything specific you want to declare about your health

Why do you want to practice yoga?

Have you practiced Yoga in the past?

If Yes, which style, where, name of teacher.

Disclaimer

I declare that the information on this form is complete and correct and I have declared all relevant details about my health and character. I am willing and able to abide by the conditions of this institute. I understand that the routines conducted at this institute (or virtually) are high impact. I shall not hold the management responsible for any emergency, medical, physical, mental or emotional complication to me before, during or after the class and no claim shall be made to the management whatsoever.
I understand that the management reserves the right to accept or refuse membership without providing any reason. I also understand that my membership to the institute may be terminated without the management having to give any reason and as such my membership may be cancelled and no claim for refund of fees shall be made by me whatsoever.
I understand that my membership is non transferable and non refundable.
I wish to enroll myself as a member of Vinod Dulal Yoga Institute (virtual/hybrid) and request you to consider my application.

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