Question Title

* 1. Please enter:
  1. First name
  2. Last name
  3. Address 1
  4. City
  5. State
  6. Zip
  7. Phone
  8. Email
  9. Emergency contact/s

Question Title

* 2. What is your current experience with yoga, meditation, or other movement and mindfulness practices?

Question Title

* 3. What is your desired experience with yoga, meditation, or other movement and mindfulness practices in the future?

Question Title

* 4. What interests you about Balance Through Movement?

Question Title

* 5. Do you have a specific intention for registering for this training?

Question Title

* 6. What is an area of your life that you would like to create change in? How will this training support that?

Question Title

* 7. Are there any elements of the program that might pose a challenge to you either emotionally or physically? Please explain.

Question Title

* 8. Joining an intensive training such as this can be a rewarding, and challenging experience at times. Do you have support from a therapist, friends, and/or family members?

Question Title

* 9. What is your current occupation or course of study?

Question Title

* 10. If you self-identify as someone from an underrepresented population within the yoga community, what kind of support would you find helpful in order to participate in this training?

T