Forms – Gurukripa Yoga

Classical Hatha Yoga Registration

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Name *

First

Last

Email *

Age *

Contact no. *

Educational Qualification *

Occupation *

Emergency Contact Name & No.: *

Residential Address *

Please describe briefly your health conditions *

Please describe briefly if there are any yoga practices you are doing regularly *

Upcoming program in Dehradun:

Bhuta Shuddhi, Ages 14 & above, November 24, 7.45 to 9 am, Fees Rs. 3850/-
Surya Kriya, Ages 14 & above, November 26 to 29-5.30 to 7.30, Fees Rs. 3200/-

Which Hatha Yoga would you be interested to learn in future:

Surya Kriya, Ages 14 & above
Angamardana, Ages 8 & above
Bhuta Shuddhi, Ages 14 & above
Surya Shakti, Ages 14 & above
Children's Surya Shakti, Ages 7 to 13
Yogasanas, Ages 14 & above
Shanmukhi Mudra, Ages 14 & above
Bhastrika Kriya, Ages 15 & above (Only for those who're regularly doing any Isha Hatha Yoga)
Sunayna, Eye Care Practice, Ages 8 & above (Only for those who have learnt any Isha Hatha Yoga already)
Jala Neti, Ages 14 & above
Yoga for Pregnant women

Mention your preferred dates:

October 2024
November 2024
December 2024
Other

For women, Are you currently pregnant or planning for pregnancy: *

Yes
No
Not applicable

Please tick the relevant option if you take any of these: *

Smoke
Drugs
Alcohol
None

Any Comments:

If there is a group of participants, we travel and teach also. So If you wish to learn the practices outside of Dehradun or Online, please fill the details here:

"By submitting this form, I hereby willingly agree to attend this program completely for all the session. I take full responsibility for the results and indemnify the organizers against all claims and suits. I agree that I will not communicate the contents of the program, either directly or indirectly to anyone else. I understand the participation guidelines and agree to follow them. I understand that I shall be allowed admission to the Class only if I have paid the fees in full. I hereby declare the above information is true, accurate and complete to the best of my knowledge." *

I Agree

Email *

The workshop will be conducted either in English or in Hindi. Please let us know your preferred language.

NOTE: Surya Kriya, Yogasanas & Bhuta Shuddhi can be learnt by anyone aged 14 & above and Angamardana ages 8 & above, no prior experience of Yoga is needed. But due to nature of the practice, Pregnant women and people with serious back disease or hernia should not practice Surya Kriya, Yogasanas or Angamardana.