Application form

Your Name*

Course start date*
—Please choose an option—9 Jun30 Jun7 July14 July18 August25 August1 September8 September29 September

Number of weeks*

Accommodation*
—Please choose an option—SingleDouble/TwinTriple/FamilyStaying elsewhere

Sharing with

Your date of birth*

Gender*

Nationality*

Passport number*

Home address*

Email address*

Mobile phone*

Emergency contact (name and mobile number)*

Occupation*

How long have you been practising Iyengar yoga?*

Do you regularly practise inversions and backbends?*

Name of your regular Iyengar teacher*

Are you an Iyengar teacher or aspiring teacher?*
—Please choose an option—YesNoBeing mentored

If so, what level and when passed?

Are you working towards a teacher assessment, and if yes, when?

Please give details of any injuries, major operations or long-term medical problems*

Please give details of any medication you are taking*

Do you have any serious dietary requirements or allergies?*

Have you been on one of our holidays before?*
—Please choose an option—YesNo

If not, how did you hear about us?
—Please choose an option—I’m a student of Marios’IYA website/magazineTeacher’s recommendationFriend’s recommendationInternet searchOther

If Other please specify

Photographs (general not individual) may be taken during classes for the purpose of sharing on our website and on social media (with tagging disabled). This is solely for learning and marketing purposes. Do you consent to be included in these?
YesNo

Please confirm that you have read our terms and conditions and will abide by them

I confirm that I will abide by the terms and conditions of ‘mariosyoga’ Yoga Holidays

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