<p> OM 300/500 Hr Teacher Training 2015 Application for Registration Prana Yoga Miami 2016</p><p>An advanced teacher training program in OM yoga: an alignment based vinyasa practice integrated with Buddhist meditation methods of mindfulness and compassion.</p><p>Which TRAINING are you registering for ? Check one ___ OM 300/500 hr Teacher Training ___ Sun Session (only) ___ Moon Session (only)</p><p>* Required information</p><p>◦ Personal Information - You can type them directly into this document.</p><p>• *First Name: • *Last Name: • *Email Address: • *City: • State: • Province: • *ZIP Code: • *Country: *Cell Phone: • *Gender • *Date of Birth • *Emergency Contact (name & phone number)</p><p>• *Does your current life and schedule allow you to fully participate in this training? (yes or no) ◦ ◦ Please answer the following questions. • *Why did you choose OM yoga Teacher Training?</p><p>• *What is inspiring you to take a 200 hr teacher training now?</p><p>• *Yoga Experience: Tell me about your practice - Where do you practice? How often? Who are your teachers? What style(s) of yoga?</p><p>• *Previous Yoga Training: Tell me about your previous yoga training experience - your teachers, what trainings or workshops, where and when. • • *Other Relevant Experience: What is you educational and professional background outside of yoga? List other training or experience that you think may be relevant (for example: pilates, therapy, etc.)</p><p>• *Health: Tell me anything about your health (past or present) that is relevant for us to know for this training. Do you have any medical conditions? Are you taking any medication?500 characters remaining • • *How did you year about this training? Friend, internet search, advertisement, yoga teacher or colleague, studio owner or manager or other? ◦ Release • Release: For consideration to practice yoga and participate to the full extent in OM yoga/Cyndi Lee's OM Yoga Teacher Training, I understand that by signing I am to discharge Cyndi Lee and OM yoga from and against any and all liability arising out of or related in any way with my participation in the event, even if that liability is caused by Cyndi Lee's conduct. I agree to assume full and complete responsibility and risk of bodily injury, property damage or any other kind of injury foreseen or unforeseen, which may occur. I understand the full cost of the program is non- refundable and non-transferable within 31 days of the start of the event. I acknowledge that Cyndi Lee or her representative may take photographs, videos or recordings of me. I agree that these may be used worldwide in perpetuity, without compensation for marketing and trade purposes. I acknowledge that any voice or video recording I make during the event are for my eyes and ears only. I will never publish in any way. • *I have read and agree to the terms of the release. ◦ I agree</p><p>______Signature (type full name)</p>