FYMP Intake info

Forrest Yoga Mentorship Programme (FYMP) — Intake form

Before we work together, I'd like to know more about you!... Your current and past health conditions and/ or injuries and your teaching experience. All of this information is confidential, if you prefer to email me your information, get in touch.

1. Your contact information

* Indicates required field

Email *

Name *

First

Last

2. Your emergency contact (friend/family member etc)

Name *

First

Last

Phone Number *

Email *

3. General information about you

Date of Birth (dd/mm/yyyy) *

Physiological gender: do you have: *

A vulva A penis Both

4. Your general health

Tell me about any past health issues/injuries/conditions/surgeries. *

What, if any, injuries/conditions/surgeries are you currently working with? *

If there is anything else you would like to tell me about your health (physical, emotional, Spiritual) feel free to share here. *

5. If you have a uterus, please answer the following questions. People with a penis, you can go directly to the next section...

Are you currently pregnant? *

Yes No

If you ARE pregnant, how many weeks? *

6. Yoga training

What yoga trainings or relevant complimentary trainings have you completed? *

If you are currently teaching yoga (in any way) to others, please share details of what you have been doing and how it is going (in your opinion) *

What would you like to get out of working with me? *

Is there any reason why you may not be able to work with me? If yes, please specify. *

7. The legal bit

By submitting this form I acknowledge that I have shared information to the best of my knowledge. I agree to take responsibility for myself during each session with Charlotte Speller. I agree for my details to be used by Charlotte Speller for marketing and communication purposes only. I understand that my personal information is confidential and will never be shared with any third parties without my consent!

IMPORTANT: During yoga classes from time to time, I may record or take photos for education or marketing purposes. If for any reason you do not consent to this, please get in touch. When participating in trainings online, the content is recorded for participants to access for a limited time after the training. The training may also be sold separately, in such cases, content will be reviewed and any content deemed personal shall be removed from the recording.

I am really looking forward to us working together soon!
LOVE Charlie

Submit

YOU & YOUR TEACHING

Forrest Yoga Mentorship Programme (FYMP) — Intake form