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* 1. Contact Information

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* 2. Emergency Contact Name

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* 3. Emergency Contact Phone Number

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* 4. How long have you been practicing yoga?

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* 5. What styles of yoga do you practice?

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* 6. How often do you practice yoga, and where?

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* 7. Have you attended any other teacher trainings or have teaching experience?

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* 8. Do you have any physical limitations or previous injuries?

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* 9. Are you enrolling in this this teacher training primarily to enrich your personal practice or to obtain qualification to teach yoga classes?

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* 10. Anything additional you would like to share about you?

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* 11. How did you hear about this teacher training?

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* 12. Training Schedule Commitment
I commit to full attendance of the outlined schedule in addition to 40 hours of independent study and yoga practice.

Training Location:
Blue Moon Yoga Clovis
850 Herndon Ave #101-B
Clovis, CA 93611
559-325-BLUE

Session 1
Thurs. Sept12: 5pm – 10pm
Fri Sept 13: 9am – 7pm
Sat Sept 14: 9am – 6pm
Sun Sept 15: 9am – 6pm
Mon Sept 16: Day Off
Tues Sept 17: 9am – 6pm
Wed Sept 18: 2pm – 10pm
Thurs Sept 19: 9am – 6pm
Fri Sept 20: 2pm – 10pm
Sat Sept 21: 9am – 6pm
Sun Sept 22: 8am – 3pm

Session 2*
Fri Jan17: 9am – 7pm
Sat Jan 18: 9am – 6pm
Sun Jan 19: 9am – 6pm
Mon Jan 20: 9am – 6pm
Tues Jan 21: 12pm – 8pm
Wed Jan 22: 9am – 6pm
Thurs Jan 23: 12pm – 8pm
Fri Jan 24: 9am – 6pm
Sat Jan 25: 9am – 6pm
Sun Jan 26: 8am – 3pm
*Exact times are subject to change

Please type your initials to confirm your commitment to the training schedule.

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* 13. Payment Options (please select one)
Note: there may be additional book fees

3% transaction fee added for debit / credit transactions

Please contact Molly Kaminski to pay by cash/check or to set up an installment plan (molly@bluemoonyogafresno.com)

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* 14. Refund Policies

Withdraws / Cancellations:

*Trainees withdrawing before the training begins by 8/12/19 will receive full refund
*Trainees withdrawing between 8/13/19 - 9/11/2019  will receive 50% refund
*Trainees withdrawing on/after 9/12/2019 will not be eligible for a refund.

Refunds will be provided in the event:
*The school cancels training at any time for any reason or training dates as it was advertised.
*The trainee is asked to leave the teacher training for any reason. A proportionate refund for any class sessions not yet taken by the affected trainee will be refunded.
*The trainee leaves by mutual agreement with the school. A proportionate refund for any class sessions not yet taken by the affected trainee will be refunded.
*Trainee fails to complete the course for medical reasons. A proportionate refund for any class sessions not yet taken by the affected trainee will be refunded.  Doctor's note is required.

All notices of withdraw/cancellation must be in writing via email to Molly Kaminski: molly@bluemoonyogafresno.com

Payments for refunds will be made within 30 days from receipt of the written Notice of Withdrawal, or within 30 days after the effective date of dismissal from the program.

Please initial in the box below to confirm your understanding of the refund policies.

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* 15. Acknowledgement: 
By signing this agreement, I understand that:
*My enrollment may be terminated if I fail to comply with attendance, academic and financial requirements, or if my behavior disrupts the normal activities of the Training.
*While enrolled in the Training, I understand that I must maintain satisfactory academic progress and that my financial obligations to Blue Moon Yoga Studios must be paid in full before a certificate may be awarded.

Please type your full name in the box below to confirm your acknowledgement of this agreement.

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