yoga-registration-form

Your Name (required)

Your age (Required)

Gender
MaleFemale

Your Email Address

Your Mobile Number (Required)

Location Nearest to You for Yoga Classes (Required)
Shivaji ParkGorakh ParkRohtash NagarNaveen ShahdaraDurgapuriBabarpurMaujpurYamuna ViharNathu ChowkChota BazarVishwas Nagar

Physical Ailments, if any.

AsthmaDiabetesCervical SpondylitisLumber SpondylitisBack PainArthritisSciaticaHypertension (High Blood Pressure)Heart ProblemNo Problems

I accept that all the above information furnished by me are true to best of my knowledge.