sample form Appaa Yoga Academy Registration Form Step-1 Step-2 Step-3 Full Name: Date of Birth Gender MaleFemaleOther Address: City: State: Pin Code: Phone Number: Email Address: Previous Next Course Selection: Please select the course you wish to enroll in: Yoga Diksha CourseYoga Fitness / Yoga Wellness ProgramAny Other Branch Selection: Please select the branch for admission: Naraina Vihar, New DelhiIndarPuri, New DelhiWELCOMHOTEL Dwarka, New DelhiPavana Nagari, Dharwad, Karnataka Timing Selection: Please select the Timing : 6 :0 0 AM to 7:0 0 AM7:0 0 AM to 8:0 0 AM8:0 0 AM to 9:0 0 AM9 :0 0 AM to 10 :0 0 AM10 :30 AM to 11:30 AM11:30 AM to 12:30 PM4:0 0 PM to 5:0 0 PM5:0 0 PM to 6:0 0 PM6 :0 0 P M to 7:0 0 P M7:0 0 P M to 8:0 0 P M Mode Selection: Please select the mode: Offline ModeOnline Mode Health Analysis: Height: Weight: Blood Pressure: Pulse Rate: SPO2 Level: BMI: *(Attach the In body 360 report with the Application) Do you have any pre-existing medical conditions? YesNo Are you currently on any medication? YesNo Have you undergone any surgeries in the past? YesNo Do you have any allergies? YesNo Do you have a history of: HypertensionDiabetesHeart DiseaseRespiratory IssuesNone of the above Do you engage in regular physical exercise? YesNo What are your primary goals for joining the yoga program? Fitness ImprovementStress ReliefFlexibilityWeight LossOverall Well-being Previous Next Emergency Contact Information: Full Name: Relationship: Phone Number: Email Address: Scan this QR to make the payment Declaration: I am voluntarily joining yoga classes, with full involvement to have positive health and well-being. I will discuss with the Yoga teacher regarding the progress in health and Well-being status at least once in three months. Agree Previous Next
