I am text block. Click edit button to change this text. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.

     


    YOGATIME STUDENT REGISTRATION FORM

     

    IDENTIFICATION

    Your First Name (required)

    Your Last Name (required)

    Where do you work?

     

     

    CONTACT DETAILS

    Your Local Phone Number

    Your Mobile Phone Number (required)

    Your Email (required)

     

     

    PHYSICAL ADDRESS

     

    Your Address - Line 1 (required)

    Your Address - Line 2 (required)

    Your Address - Line 3

    Suburb

    City (required)

    State (Applicable only for addresses outside Singapore)

    Postcode (required)

     

     

    POSTAL ADDRESS

    Your Address - Line 1 (required)

    Your Address - Line 2 (required)

    Your Address - Line 3

    Suburb

    City (required)

    State (Applicable only for addresses outside Singapore)

    Postcode (required)

     

     

    ADDITIONAL DETAILS

    Occupation

    Referred by

     

     

    IMPORTANT

    Gender (Required):   FemaleMale

    Contra Alerts (Required)

     

     


    DECLARATION

    I declare that the above information provided to YogaTime is true and accurate, and agree to the following terms:

    1. That as both a responsibility of a student and a registration requirement at YogaTime, I will inform the studio, it’s teachers or owners of any change in the information above within a period of 14-days.

      2.  

    2. I expressly accept and assume all of the risks inherent in my participation of activities or that might have been caused by the negligence of YogaTime, its owners, its teachers, instructors and/or representatives, advisors, employees, agents, volunteers, participants, and all other persons or entities acting for them. My participation in activities offered by YogaTime is purely voluntary and I elect to participate despite the risks. In addition, if at any time I believe that event or activity conditions are unsafe or that I am unable to participate due to physical or medical conditions, then I will immediately discontinue participation

      3.  

    3. I understand that yoga, as well as other activities provided by the Releasees can involves hands on correction and I agree to give my consent for this

      4.  

    4. I agree to inform the teacher of any pain or discomfort experienced during or after a Yoga class

      5.  

    5. I agree to inform the teacher of any changes in my health after signing this declaration

      6.  

    6. I agree and consent to the use of any photos and, or videos taken of me during class, workshops, events and/or activities may be used for marketing purposes only.

     
     

    (On a PC, click on the space below "Your Signature" and use your mouse or trackpad to sign this form below. On a smartphone or tablet, simply use your finger or stylus to sign. Use the CLEAR button to clear your signature if you need to re-sign.)
     
    Your Signature (Required):
    [signature* signature-release cols:500]

     

    Your Full Name (required)

    Date (required)

    Identification Number (required) Singapore NRICSingapore FINPassport