Svastha Yoga Therapy Program
Registration Form

Kia ora!

Thanks for your interest in attending the Svastha Yoga Therapy Program. I’m delighted that you are wanting to join the program and I look forward to sharing this journey with you.

Please take the time to complete the registration form below and I will be in touch to confirm that your registration and payment of the deposit has been received.

If you are unable to pay your deposit now, or if you have any questions about the program, please email me below.

Thanks again.
Ngā mihi
Barbara

Contact Barbara

About You:
Your Name*
First Surname
Email Address*
Enter Email Confirm Email
Contact Phone Number*
Which Module are you registering for?*
Address*
City Country
Emergency Contact Details*
Name Telephone Number Relationship
How did your hear about this program?*
- Recommended by a friend
- Google search
- Social Media
- Newsletter
Yoga Teacher Training Details*
Would you like to subscribe to Barbara's newsletter and be updated on future programs, workshops & latest news?*
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Note: your information will never be shared and you can unsubscribe from the newsletter at any time.
Payment by Credit Card*
- Deposit (nonrefundable) - $200.00
- Full Earlybird - 747.50
- Full Regular - $805
If you prefer to pay by Bank Transfer, please select your payment amount above & then click the Book and Pay button and exit when you reach the PayPal page. This will ensure your registration form is submitted.

Direct Transfers can be made to 06-0199-0125926-02

Please note that registration is confirmed only on receipt of the $200 non refundable deposit.
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6 Prime Road | Grey Lynn | Auckland 1021

m: 021 170 2640
e: [email protected]

Svastha Yoga Therapy Program Registration Form

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Svastha Yoga Therapy Program
Registration Form