Yoga Retreat Participant Questionnaire

Breath by Breath

True for You Yoga Retreat Participant Questionnaire

TFYYoga Retreat

TFYYoga Retreat Dates

TFYYoga Retreat Location

Name

First Name

Last Name

Phone

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth

YYYY

Time of Birth (Most accurate time that you know of)

Location of Birth

Occupation

Gender

Female

Male

Emergency contact (Name/Phone/Relationship)

Tell us about you..

Have you ever traveled to a foreign country before?

Do you currently have a valid Passport with at least 6 months before the date of expiration?

Have you ever had an astrology reading before?

How long have you practiced Yogasana? (Physical yoga postures)

Truthfully, how often do you practice Yogasana per month, now?

What styles of Yoga do you practice? Where?

Do you feel breath awareness important in your Yoga practice?

Do you practice meditation regularly?

Who is your most notable Teacher/Guru in your Life? Why?

What other movement and mindfulness practices do you have? How long and how often do you spend doing these practices per week?

Do you currently teach Yoga? If Yes, what styles?

Would you like to teach Yoga and/or Meditation for a living? Why or why not?

Are you teaching fully Self-expressed? Why or why not? (If applicable)

Would you like to teach fully Self-expressed? Why or why not? (If applicable)

Would you like to have a daily Yoga/Meditation practice? Why or why not?

Would you like to experience the healing power of a sustainable daily Yogasana practice during your retreat experience? Why or why not?

What is your current level of surfing experience?

If you've never surfed before would you like to learn how to surf during your retreat experience?

Would you consider yourself a 'strong swimmer' and very comfortable in ocean water?

Do you have any current or past injuries or physical limitations that would be important for us to know as Retreat Leaders?

Are you taking any prescription medication?

Do you have any special dietary needs or restrictions?

This retreat experience can possibly be quite physically involved at times. Have you had a physical exam by a doctor in the last 6 months that would assure you that you can attend?

Last but not least -- At the completion of this TFYYoga Retreat experience what would you like to come away with, and why did you choose this retreat?