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We appreciate your interest. Please help us with your details and our team will get in touch with you at the earliest possible

Personal Information

Name

Age

Gender

Male Female Other

Contact Details

Country Code

WhatsApp Number

Email ID

Country

City

Address

Emergency Contact

Emergency Contact Name

Relationship

Emergency Contact Number

Health & Medical History

Do you have any existing health conditions (e.g. back pain, blood pressure, diabetes, injuries)?

Yes No

If Yes, please specify:

Are you currently taking any medication?

Yes No

Any restrictions advised by your doctor?

Yoga & Fitness Background

Have you practiced Yoga before?

Yes No

If yes, for how long and what style?

What are your goals for joining our classes?

Weight Loss Stress Relief / Mental Health Flexibility Therapy (Back Pain, etc.) General Fitness Spiritual Growth Others

Any another information you wish to share with us

Preferred Class Timing

Class/Program you have opted?

Offline/Daily Yoga Classes (Mon-Fri) Online/Daily Yoga Classes (Mon-Fri) Tridosha Yogasans Youth Transformation Program Female Wellness Program

Batch Timing

Morning Batch Evening Batch

Declaration Agreement

I declare that the information provided is true and I take full responsibility for my health during practice at Nirvikalp Yog Studio.

Nirvikalp Yog Studio is located in lush greens of Dehradun, canal road.

Our Goal is simple and it is just your transformation to help you to achieve your health goal.

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