MTY Registration Form

Note : In case if you want to pay directly without filling up the form Click Here

Select a course *:

Starting date of the course * :

Choose location *:

Choose formula *:

Choose method of payment *:

Full name and surname*:

Gender *:

Date of birth *:

Nationality *:

Current occupation*:

Full address *:

Email address *:

Phone/Whatsapp number *:

Emergency contact person (name and phone number)*:

Do you have any medical condition (serious illness in the past years/chronic physical limitations/currently taking medications/history of psychological or emotional illness/anything else you would like us to know). If yes, precise *

How did you hear about us? *:

What makes you to choose Mukta Tantra Yoga?*:

What is your experience of yoga?*:

What is your purpose for this training/retreat and what do you hope after?*:

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*All fields are required to be filled. Please note that we may get back to you to discuss your application and assess that our course is the right training for you. Thanks.*

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