Yoga Teacher Training

Name

First Name Last Name

Email

example@example.com

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

Area Code Phone Number

Occupation

Emergency Contact & Relationship

Emergency Contact Phone Number

Do you have any pre-existing conditions that we should be aware of (physical or mental) that could potentially impact your participation in the training?

Will you be on any medications during the training?

Yes No

Do you have any conditions that could need medical attention during the training?

Yes No

If yes, what is the condition?

Tuition

Module 1 ($1700) July 20 - 29, 2017 Module 2 ($1700) November 23- December 1, 2017 Module 3 ($1700) March 15 -24, 2019 All 3 Modules- Regular Price ($4200)

REGISTRATION & DEPOSIT

A non-refundable deposit is due with upon submission of your application to reserve your space. This deposit is only refundable if you are not accepted to the course you are applying for.

Late Registrations: If you are registering after the balance due date, the full tuition is due with your application to reserve your space.

BALANCES DUE:

50% of the tuition is due 3 months prior to the commencement of the teacher training. Final payment is due in full one month prior to the commencement of each modules. If we do not receive payment in full by the applicable due date, your place may be offered to someone on the waiting list and the deposit will be forfeited.

REFUND POLICY:

If a trainee withdraws from the program, the Deposit is non-refundable and non-transferrable.

If a trainees withdraws 60 days+ from the program, 50% of the cost is refunded, less the deposit.

If a trainee withdraws 30 days+ from the program, 25% of the cost is refunded, less the deposit.

If a trainee withdraws less than 30 days from the program's commencement, full cost is forfeited.

EVENT CANCELLATION:

In the unlikely event the program is cancelled, full payments including deposit will be refunded.

Travel expenditures will not be reimbursed, and are considered each individual's own liability. We strongly encourage students to purchase Travel Insurance.

Agreement Checklist

I understand that the deposit is non-refundable I will submit full payment by the applicable due date I understand that missing 3+ days in the training may result in a loss of certification

Liability Waiver:

Christina Gagnier and Marysia Do offer a variety of yoga retreats and trainings internationally. Some of the programs on this training require physical exertion, which may be strenuous and may cause physical injury. We recommend that you consult your physician before beginning any program. Students must listen to their own bodies and work within their own limitations. If any movements hurt or are uncomfortable; it is your responsibility to never take any exercise to a level of discomfort or pain.

Notice is hereby given that all arrangements made on behalf of participants are made by the organizers on the sole condition that the organizers shall not be held responsible for any injury, death, accident, illness, delay, loss, damage, act of negligence, or irregularity. The undersigned hereby also agrees to indemnify and hold harmless Christina Gagnier and Marysia Do or any other instructors or facilitators, from and against liability, damages, costs, loss or expense (including without limitation, attorney’s fees) arising out of any bodily injury, illness, or loss at any time sustained by the undersigned.

I have read and understand this:

YES

My Products

Single Module Deposit $ 300.00 AUD

Full Training $ 500.00 AUD

Total $ 0.00 AUD

Signature

Clear

THE EMPOWERED YOGI TEACHER TRAINING Melbourne, AUS