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Online Yoga & Relaxation Classes Expression of Interest
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1.
Background
(Required.)
Name:
Mobile Number:
Email:
Geographical location (County):
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2.
Participant's Details:
(Required.)
Name:
Age:
*
3.
What type of disability does the participant have? (This programme is most suitable for - Intellectual Disability, Autism Spectrum Disorder, Dyspraxia, Motor Coordination Difficulties)
(Required.)
Physical
Intellectual
Autism Spectrum Disorder
Motor Coordination Difficulty
Sensory Disability
Dyspraxia
Other
Other (please specify)
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4.
Please provide us with details that may help us understand any individual requirements or needs.
(Required.)
*
5.
Does the time of the session suit you? Monday and Wednesdays from 11.15am-11.45am?
(Required.)
Yes
No
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6.
Do you have Zoom?
(Required.)
Yes
No
7.
We welcome any other comments or feedback you might have.
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