YOGA Psychology & Meditation Course RegistrationPlease complete the details below to enrolIf you have any questions please call us on 0407392666 Name * First Name Last Name Address * Email * Phone Number * (###) ### #### Occupation * Emergency Contact Name * First Name Last Name Emergency Contact Phone Number * (###) ### #### How did you hear about this course? * Internet Newsletter Classes Poster/Flyer Friend Other Where? If you selected "internet", "poster/flyer", or "other", we'd love to know where you found out about us! Do you have previous yoga experience? * If you do, please describe your experience. Do you have other qualifications in health and fitness modalities? * This includes yoga training qualification. Do you have a meditation practice? * What is your preferred way of sitting for meditation? * Select Floor Wall Support Chair For what reason are you intending to study with Shantarasa? * To teach To deepen personal practice and understanding For professional development Do you have any injuries or structural difficulties at present? * Have you had any medical procedures in the last 5 years? * Do you have any medically diagnosed conditions? * Have you experienced a diagnosed condition of depression/anxiety in the past 7 years? * How would you describe your present level of health? * How would you describe your present level of fitness? * Is there anything else we need to know to guide you safely in your yoga training program? Select your training * Adelaide - Yoga Psychology & Meditation Adelaide - 500-Hour Yoga Teacher Training Adelaide - Pre-Postnatal Yoga Teacher Training Adelaide - Applied Ayurveda Adelaide - Yoga Nidra Training Preferred name on course certificate? Payment method * DIRECT DEPOSIT (Preferred Method) Account name: Shantarasa School of Yoga & Meditation BSB: 015 650 Account number: 478 269 594 *Please note your name as the payment reference Please send payment confirmation to admin@shantarasa.com If you would like to pay by credit card there is a 2% surcharge. Please call 0407 392 666 to make a credit card transaction. Pay in full $1100 (bank transfer) Payment Plan 1 | Deposit $500 + Instalment $600 before training commencement Payment Plan 2 | $100 x 11 weekly payments I want to pay by credit card PAYMENT, REFUND & COURSE DEFERMENT POLICY * • Non-refundable deposit $500 to secure training registration / with course deferment option • Fees are to be settled minimum 14 days prior to training if paying in one payment • Course refund available up to 14 days prior to course commencement less non-refundable deposit • No refunds after course commencement (course deferment will apply). In some situations where circumstances are unavoidable or extenuating some remittance can be negotiated. • Deferment of course or intensives available in consultation with course administrators I agree to payment and refund terms and conditions Thank you!