yoga simran
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privates questionaire

Please complete the below with your details:

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Name *
E-mail Address *
Telephone # (best to reach you) *
Telephone # (other)
Address (include city and country)
What type of privates are you interested in? *
Do you prefer? *
Do you prefer? *
What do you need that privates will help with? *
What do want to gain from privates? *
Have you taken privates before? How was the experience? *
Yoga experience *
Where do you want to do the private classes? *
Do you have injuries? health concerns? *
Women: if you're pregnant, how far along? what is your due date? how do you feel?
Do you want to receive emails on future offerings? (usually once a month) *
How did you hear about us?


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