Email Address

Telephone Number

Aims (optional)

Please summarise what you would like to achieve through yoga

Experience

Please describe any previous experience with yoga (don’t worry if you don’t have any)

Limitations

Please outline any physical limitations/injuries/health condition that the yoga teacher should know about.

Medical Information

Please provide details of any other relevant medical treatment/ operations/ medication

Fees

Please contact the teacher to arrange payment.

Cancellations

If you can’t make a class, to avoid being charged, please let me know at least 24hrs in advance to re-schedule your appointment.

Privacy & Confidentiality

Any personal information you have shared with us will be kept confidential and only passed on to your Yoga teacher. We will not share any of the information you have provided here with any third party.

Sign up to our newsletter

Would you like to sign up to our newsletter to stay up to date with classes, retreats, workshops and more?

Private Lesson Registration Form

with Naomi Hayama