Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone number

Country

(###)

###

####

Is English your first language?

Yes

No

Have you had any major physical or emotional illness within the past 5 years?

Yes

No

Are you under medical or psychiatric supervision?

Yes

No

If your application is successful, which payment plan are you interested in? *

Deposit + balance in 30 days

Deposit + 3 payments

Deposit + 10 payments

Deposit + 18 payments

I have detailed above any known medical or physical concerns *

Yes

No

I agree to the T&Cs *

We will honor all cancellations and refunds for online trainings up to the start date of the training or course. Once the training has started you are financially committed to fulfil any payment plans or outstanding fees. If something comes up during the training and you need to defer then you are welcome to join us the following year but payments must be honoured. If you have had any major physical or emotional illness within the past 5 years, or are under medical or psychiatric supervision, you must notify us of the details at the time of booking. Please click the link and make sure you have read our policies before you submit your application. https://www.samavesayoga.com/terms-and-conditions

Yes