Registration for IYENGAR YOGA COURSE
Which course do you wish to attend:
February 7th - 17th 2012
September 21st - 30th 2012
October 2nd - 11th 2012
October 13th - 22nd 2012
Name
Gender
Select
Male
Female
Age
Date of birth
Country
Address
Phone No.
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Main:
Res:
Mob:
E-mail
Profession
The next of kin of person who can be contacted in case of need/emergency:
Name
Relationship
Address
Phone
Email
Since when are you practicing or teaching?
With whom and where?
Do you have chronic illness?
Yes
NO
(if yes, please state the nature of the illness)
How do you know about this course?
Other information about yourself & Remarks
- Swami Dayananda Ashram, Rishikesh -