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YTT Application
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Home
New Students Locations
NEW STUDENTS
Lacey Location
Tumwater Location
Class Schedule
Account/Store
Blog
Reviews
Yoga Teacher Training
Teacher Training
200-Hour Yoga Teacher Training
300-Hour Advanced Yoga Teacher Training
YTT Application
SPECIAL EVENTS
Online Extras
DOWNLOADS
Recorded Yoga and Meditations
Intuitive and Healing Services
Yoga Therapy @ Firefly Yoga
Yoga teacher training Application
Name
*
First Name
Last Name
Email Address
*
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone number
Birth date?
MM
DD
YYYY
Which training are you interested in? 200 hr Spring, 200 hr fall or 300 hr advanced
How long have you been practicing yoga?
How often and how long do you practice?
What styles of yoga do you primarily practice?
Do you have a meditation practice? If yes, please describe.
Please tell us about your education level and work history.
Are you under any kind of medical care? Please describe condition and treatment, please include injuries, mental health and chronic illnesses.
Any special dietary needs?
Emergency Contact
Name and phone
1. Please provide a description of your typical yoga practice, including examples of postures you practice during a typical session.
2. Besides yoga, please list any other types of physical activity you typically engage in and how often (e.g., running—3 times a week; dancing—once a week.)
3. Why do you want to be certified as a yoga teacher at this time in your life?
How did you hear about us?
PHOTO and SAFETY RELEASE I release Firefly Yoga and its owners, employees, and agents, and hold them from any and all liability arising out of any personal injuries or damages, foreseeable or unforeseeable, which may occur as a result of my participation in any class, program or activity sponsored by Firefly Yoga. I hereby declare myself physically and mentally sound and capable of participation in those activities, programs and classes. I understand that our classes include physical movements as well as an opportunity for relaxation, stress re-education and relief of muscular tension. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will listen to my body, adjust the posture and ask for support from the teacher. I will continue to breathe smoothly. Our classes are not a substitute for medical attention, examination, diagnosis or treatment. Physical exercise is not recommended and is not safe under certain medical conditions. I affirm that I alone am responsible to decide whether to participate in these classes. I hereby agree to irrevocably release and waive any claims that I have now or hereafter may have against Firefly Yoga and any of their affiliates. I give Firefly Yoga and Lisa Cosmillo permission to use any images of me for marketing, promotion or display.
*
Initial in the box below:
All tuition or a signed tuition agreement are due prior to the first day of the training. All tuition is nonrefundable once the training begins.
Type initials below:
I have answered all questions, fully and truthfully, to the best of my knowledge, regarding my health and medical conditions. Student Signature:
*
Type full name and email address below:
Date:
Thank you!
