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Booking page for Orangetree bookings
Please note that all fields followed by an asterisk must be filled in.
Course and Date*
First Name*
Last Name*
E-mail Address*
Street Address*
City*
State/Prov*
Zip/Postal Code*
Country*
Home Phone*
Business Phone
Fax
Occupation*
Your Age*
How many years have you practised Yoga?*
How many years have you practised Iyengar Yoga?*
Do you regularly practice headstand?*
Yes
No
Occasionally
Do you regularly practice Shoulderstand*
Yes
No
Occasionally
Do you have any allergies?*
Do you have any special dietary requirements?*
What do you hope to achieve during your stay?*
How did you hear about us?
Please also state which retreat week time you wish to attend*
Please tell us of any serious medical condition
Do you have any muscle or joint problems?
Are you currently on medication or receiving medical treatment?
Are you pregnant?
Important Health Information (read carefully and then tick yes to show you have understood and read the information) Holiday yoga classes are not suitable for those with certain medical conditions. These include the following: Hypertension, Heart Disease, Cancer or Benign Tumour, Epilepsy, Diabetes, Meniere's Disease, Detached Retina, AIDS, MS, ME, recent Post Operative conditions, Pregnancy. In such cases a specialist yoga class should be sought. If you have any queries or would like more information on remedial yoga classes available in the UK, please let us know. Please advise us if you have any condition or injury not mentioned above. Please also check with your medical practitioner.*
Yes, I have understood and read the above, advised you of any condition or injury and this tick constitutes my electronic signature