Seniors and Bone Strength YTT (In-Person) Application

Name*

First Last

Address*

City State / Province / Region ZIP / Postal Code Country

Email*

Enter Email Confirm Email

Phone Number*

Which course dates are you applying for now?*

May 19-22, 2024
2024 dates don't work for me. Please notify me when 2025 dates are chosen.

What type of yoga do you practice and how often are you practicing?*

What is your experience with meditation?*

Which Registered Yoga School have you completed your 200-hr training with? (If you have not completed a 200-hr YTT, what yoga training have you done that has prepared you for this course?)*

How much experience do you have teaching yoga and who are/were your students?*

E.g. What style of yoga to do you teach and how often?

Why do you want to take this course?*

Ananda takes a classical approach to Yoga: as an aid in the quest for Self-realization, for union of soul with Spirit. Although this training program takes place in that spiritual context, trainees are not expected to follow Ananda’s spiritual path; we encourage you to grow on your own path. Does this seem like a good fit for you?*

Yes
Not sure

Medical Questionnaire: What is your birthdate? (Day, Month, Year)*

Please briefly describe your current overall health.*

Describe your history (include dates) of back/spine/neck problems, and indicate if you are currently having any issues. Please be specific.*

Describe your history (include dates) of joint problems (knee, hip, shoulder, etc.), including joint repair/replacement surgeries. Please be specific.*

When was the last time your blood pressure was checked and was it normal, high, or low?*

Are you pregnant? If yes, when is your due date?

Are you currently seeing, or have you seen in the last 5 years, a physician or therapist for any physical or mental/psychological conditions? If yes, for what conditions?*

Are you currently taking medication for any physical or mental/psychological conditions? If yes, what medications, for which conditions, and how frequently?*

If you have any learning disabilities, or other special physical or mental/psychological circumstances, please explain below.*

Please check any of the following difficulties you have had and explain relevant specifics in the next question.*

Please explain the above health conditions you checked off in greater detail and with relevant dates.*

If you have questions or concerns about your diet, please elaborate in detail. Important Note: Our kitchen offers a varied selection of vegetarian cuisine daily; we can provide dairy-free and wheat-free alternatives, but some special dietary requirements are beyond our ability to accommodate.

Do you smoke? (If you do smoke it is essential that you ONLY smoke in designated areas both for the wellness of our guests and because we are in an extremely high fire danger area.)*

Yes
No

I hereby certify that the above information is correct to the best of my knowledge, and I will continue taking all medications as prescribed by my health care practitioners(s) while staying at The Expanding Light Retreat.*

Yes
No

Please share any other personal information that you feel we should be aware of, or concerns that you may have about this course.

Emergency Contact Name*

First Last

Relationship*

Emergency Contact Phone Number*

Are you a Registered Yoga Teacher looking to receive Yoga Alliance Continuing Education hours for this course?*

Yes
No

Are you a Registered Nurse looking to receive CEUs for this course?*

Yes
No

RNs will be need to complete an additional assignment in order to receive CEUs. Please contact the course director for details: melody@ananda.org.

How did you first find out about this course?*

Have you taken any courses/classes with Ananda online or in person, or visited The Expanding Light and/or been involved with an Ananda center?*

Free Introduction to the Path of Kriya Yoga