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Circle Of Inner Light

Registration
for

In-The-Now Yoga
Body-Mind-Spirit integrative

Virginia Collins    Certified Yoga Instructor/Yoga Alliance Registered

6:30 pm to 8:00 pm        Thursday Evenings         On-going
held at: Swedenborg Chapel, 4815 Broadview Road, Cleveland, 44109

Cost:

$10/session 
    

Please pay by check, money order (or cash at first session) for 8-week sessions.
See below to pay by  credit card or Paypal account.

For sessions and specific dates see current general flyer

FIELDS MARKED WITH * ARE REQUIRED
Your Name:*         
Your Address:*      
Phone/Cell:*        
e-mail:             

Helpful instructor information:
Have you ever taken Yoga before?      Yes     No
If so, what type?    
Do you have any medical/health-related challenges?    Yes     No
If yes, Please provide a brief description:   

Age:  10-20    20-30   30-40   40-50     50-60     60+
Other information you wish to share pertaining to Yoga practice? 
Click on submit to send via email to:
LTeacherforLife@aol.com or www.circleofinnerlife.com
or print this form and send it by regular mail to:
Virginia Collins, In-The-Now Yoga, 1607 Cook Avenue, Cleveland, Ohio 44109