Ibiza funky yoga retreat - Client Information Form 2020 - By Antonella Curti

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Question 1

NAME - SURNAME

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Question 2

YOUR COUNTRY :

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Question 3

SEXE :

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Question 4

EMAIL :

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Question 5

BIRTH DATE :

Question 6

OCCUPATION :

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Question 7

DATE OF THE RETREAT :

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Question 8

Emergency Contact
Details and Relationship to Contact :

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Question 9

Your yoga practice
Have you practiced yoga before? If so, please give details: how long, how regularly, what style of yoga, level etc. *

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Question 10

What are you hoping to get out of this yoga retreat? This could relate to mind, body or the beautiful spirit. Anything goes….

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Question 11

Do you have an all time favourite asana (yoga pose) that you love to practice?

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Question 12

Your Health
Which three (or more) words would you use to describe how you are feeling in yourself at the moment?

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Question 13

Do you have any illness, medical condition, disability or allergy? If so, please state details. *

Question 14

Are you (or could you be) pregnant? *

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Question 15

Have you suffered any injury or undergone any surgery that may have some bearing on your yoga practice? If so, please state details. *

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Question 16

Are you taking any form of medication that may have some bearing on your yoga practice? If so, please state details. *

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Question 17

Do you have any specific dietary requirements or allergies (i.e. Vegan, Vegetarian, nut/gluten allergies)? *

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Question 18

Insurance
WE STRONGLY RECOMMEND THAT YOU HAVE FULL TRAVEL INSURANCE TO COVER FLIGHT CANCELLATION, DELAY AND CURTAILMENT, MEDICAL EXPENSES AND PERSONAL BELONGINGS.
Our priority is to keep you as safe '& happy as possible throughout your Ibiza Funky yoga retreat. Unfortunately we can’t always control everything and so it is a must to have travel insurance in place if you are going to join us on Ibiza funky yoga retreat. We strongly recommend that you purchase travel insurance. I AGREE

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Question 19

You should also check with your doctor that you are sufficiently fit and healthy to undertake yoga classes. Please check with your own doctor that you are adequately fit. If you experience any injury or discomfort during any activity organised for you, then you must stop immediately and advise your Ibiza funky yoga Retreat Team accordingly. I AGREE

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Question 20

Date - signature