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Personal Information
Full Name*
Email*
Contact No/WhatsApp No:*
Date of Birth*
Age*
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Educational & Physic Information
Education*
Occupation*
Height (cm)*
Weight (kg)*
Blood Group *
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B+
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AB+
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Favorite Color*
Taste Preference*
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Address*
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Diet Information
Diet Preference*
Vegetarian
Vegan
Non-vegetarian
All of the Above
Medical History*
SUGAR / DIABETES
BLOOD PRESSURE
IRREGULAR PERIODS
BACK PAIN
THYROID PROBLEM
CONSTIPATION
PCOD / PCOS
BREATHING PROBLEM
OBESITY
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UNDER MEDICATION?
ANY OPERATION?
SMOKING HABIT?*
CHAIN SMOKER
VERY RARELY
NO
LIQUOR DRINKING HABIT?*
YES
OCCASIONALLY
NO
PURPOSE OF JOINING YOGA?*
WHO REFERRED YOU TO US?*
IF YES, KINDLY SHARE YOUR EXPERIENCE
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Prefereneces
BATCH TIMING*
Group class 5AM IST (Mon - Friday Online only)
Group class 6:15 AM (Daily, Offline only)
Kids advance yoga 06:15AM - 07:15 AM (Offline)
Group class 7:30 AM - 08:30 AM (Mon - Friday) (Online / Offline)
Prenatal Class 11:00 AM - 12:00 PM IST (Mon - Friday Online)
Personalised one on one classes (Online / offline)
Other
If you are opted for Personalised class then select the mode
Online
Offline
Choose the topic which you are more interested*
Hatha Yoga
Ashtanga Vinyasa / Hatha vinyasa
Asana + Pranayama + Meditation
Face Yoga
Cardio Yoga
Yoga therapy for back pain / indigestion
Chest opening
Hip Opening
Blind Fold Yoga
Yogalates / Pilates
HIIT
Twisting / Detoxifying
Full body stretching
Strength training without equipment
Inversion
Other
Preferable days, times, and monthly session preference (IST)*
Date of Joining
Photo*
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of the yoga classes
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