First and Last Name * Email Address * Physical Information On a weekly basis, I engage in physical activities * Less then once a week 1 - 3 times a week 4 - 6 times a week 7 time a week or more Please select one option that best describes the number of times you engage in physical activities of any kind, i.e. walking, running, hiking, biking, yoga, weight training, fitness/exercise classes etc. Do you have any physical issues or areas of concern you want the facilitator(s) to be aware of? * Do you practice Yoga? * Yes No What types of Yoga have you participated in and/or practice? * Describe in detail your current Yoga practice (if you have one) what types of yoga you have done, what are your favorite types of yoga if you have any, what you know about Yoga, what you are interested in learning about Yoga and anything else regarding Yoga you would like your facilitator(s) to know about you and your relationship with Yoga. Mental and Emotional Information Describe your current mental and emotional state of being * Are you working on any personal issues that you want your facilitator(s) to be aware of? Do you Meditate? * Yes No What types of Meditation have you participated in and/or practice? * Describe in detail your current Meditation practice (if you have one) what types of Meditation you have done, what are your favorite types of Meditation if you have any, what you know about Meditation, what you are interested in learning about Meditation and anything else regarding Meditation you would like your facilitator(s) to know about you and your relationship with Meditation. Spirituality and/or Religious Do you have a Spiritual and/or Religious Practice? * Yes No Do you attend any types of Spiritual or Religious type functions on a regular basis? Describe your relationship with your Spirituality and/or Religious beliefs * Understanding this can sometimes be a delicate topic of discussion, please share as much or as little about this area of your life that works for you. From a holistic standpoint, this is a vital piece of our life and being in balance, so the more you are able to share the better the facilitator(s) can accommodate your needs in this area. Intentions and Outcomes As always, the more we are able to articulate what we want, the better chance we actual have at manifesting our desired outcomes. These final questions are the most important part of this questionnaire. Please take the time to think about these questions and answer in as much detail as possible. What do you want to get out of your participation in this workshop? * What do you believe is currently holding you back from already having what you want? * Is there anything else you would like the facilitator(s) to know about you to ensure your needs are met and you are fully supported during this workshop? * What numbers and/or letters do you see in the below image? Type those numbers into the box below the image and hit the submit button to complete your questionnaire. Δ
