Online Group private yoga registration form
Please fill in the form below to register for your Online Private Yoga.
*mandatory fields.
About me
First Name
*
This field is required
Last Name
*
This field is required
I am a PURE Cardholder
*
Yes
No
This field is required
Cardholder Number
*
This field is required
Mobile number
*
This field is required
Email
*
This field is required
ABOUT THE STUDENTS
How long have you had a consistent yoga practice?
*
Less than 6 months
6 months to 1 year
1 to 3 years
3 to 5 years
More than 5 years
This field is required
Please disclose any injuries and/or any medical or physical conditions that may prevent participating students from engaging in physical exercise
*
This field is required
Are any of the participating students pregnant?
*
Yes
No, N/A
This field is required
How many weeks into the pregnancy?
*
ACTION PLAN
What is the primary interest or collective goal of the participants taking this Online Group Private Yoga class?
*
This field is required
What is the preferred schedule for this Online Group Private Yoga class? You can choose more than one option.
*
Morning
Lunchtime
Afternoon
Evening
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
This field is required
What are the preferred time slots? Please indicate your preference according to Singapore time (GMT +8). You can choose more than one option.
*
6am-9am
9am-12pm
12pm-2pm
2pm-6pm
6pm-9pm
This field is required
Which gender would you prefer for your Pure Yoga teacher?
*
Male
Female
No preference
This field is required
Please pick your preferred language of instruction. You can choose more than one option.
*
Mandarin
Cantonese
English
This field is required
Any other important information you would like to provide for your Online Group Private Yoga classes?
*
This field is required
If you already have a preferred teacher, please let us know their name. Otherwise, we will find a suitable teacher based on your provided information. Please note that not all Pure Yoga teachers are available for Online Group Private Yoga.
*
This field is required
Submit