First Name

Last Name

Email

Phone Number

Street Address

City

State

Zipcode

Emergency Contact Name, Relationship + Phone Number

What is your current occupation? How many hours do you work on average in a typical work week?

Do you have a 200 hr teacher training certification?
YesNo

If yes, please share details of past trainings (dates, styles, where you took the training, etc.).

Why are you interested in participating in the Radiant Mama Prenatal Yoga Teacher Training?

What does your current yoga practice look like? How many times do you practice yoga asana weekly? Do you have a meditation practice?

Please share a little more about yourself. What are your interests? How do you spend your time?

How would you describe your current health? Is there anything we should be aware of concerning your health, mental state, current or past medical history, hospitalizations, or medications?

Do you need to set up a payment plan for your PYTT tuition?
YesNo

Is there anything else we should know about you?

By clicking this box you are applying for the Radiant Mama Prenatal Yoga Teacher Training at Radiance Power Yoga. You acknowledge that your deposit of $250 is non-transferable and non-refundable. In the event that you are not accepted to PYTT Program, we will issue a refund of your deposit. You acknowledge that you are fully committed to attending all scheduled sessions and commit to full participation and meeting all requirements for successful completion of this program. You are aware that any missed hours will result in a $50.00 per hour make-up fee, to not exceed 5 hours. You are aware that it is your responsibility to clearly communicate any need for a financial payment plan and understand that all payments must be made on time and tuition must be paid in full prior to the start of program (unless you have an agreed upon payment plan in place) to complete this program. You have fully read the description of the program, communicated any questions and agree to acquire any required texts.