REGISTRATION FORMVikasa Yoga teacher training Name* First Last Email* Enter Email Confirm Email Country*Contact No*Instagram Upload your photoAccepted file types: jpg, gif, png, pdf.Gender*MaleFemaleBirthday* Date Format: DD slash MM slash YYYY How did you find out about the course? (can select more than one)* Facebook Instagram Google Search Friend / Graduate OtherIf other, please describe:*Insert referral code from affiliate here if applicable:Affiliate Program - Get $100 extra DiscountWhat was the primary reason for choosing this Yoga Teacher Training?*Early Bird Calculator* Date Format: DD slash MM slash YYYY Early Bird CalculatorWhich course would you like to attend?*200 hour FOUNDATION RYT-200 - Oct 27 – Nov 24, 2019 - $4,000.00 (SOLD OUT)300 hour UNIVERSAL RYT-500 - Nov 26, 2019 - Jan 4, 2020200 hour FOUNDATION RYT-200 - Apr 5 – May 3, 2020 - $4,000.00300 hour ADVANCED RYT-500 - May 7 - Jun 11, 2020 - $5,000.00200 hour FOUNDATION RYT-200 - Sep 15 – Oct 13, 2020 - $4,000.00100 HOUR YIN YTT RYT-100 - DEC 8 - 22, 2019 (SOLD OUT)Room for May/June 2020 Advanced CourseYoga Cave - $1,125.00Zen Bungalow - $1,500.00Beach Bungalow Standard - $1,500.00Beach Bungalow Superior - $1,875.00Ocean Room - $2,250.00I don't need a room - $0.00Room for Oct/Nov 2019 Foundation CourseBeach Bungalow Standard - $1200 USD (SOLD OUT)Beach Bungalow Superior - $1500 USD (SOLD OUT)Ocean Room - $1800 USD (SOLD OUT)Ocean Room Superior - $2400 USD (SOLD OUT)I want more info about alternative accommodationI don't need a room - $0.00Monthly Income*I am applying for this scholarship because...*What goals do you have?*What's included in the scholarship: - Tuition Fee - Meals (2 buffets per day) - Accommodation (chosen by Vikasa Team)Upload copy of your ID document*Accepted file types: jpg, gif, png, pdf.Can be drivers license, ID Card or any other document with photo.Which parts would you like to attend for Universal Yoga?UNIVERSAL YOGA - Nov 26, 2019 - Jan 4, 2020 - Full Course (3 Parts)UNIVERSAL YOGA - Nov 26 - Dec 22, 2019 - Part 1 & 2UNIVERSAL YOGA - Dec 22, 2019 - Jan 4, 2020 - Part 3 OnlyAccommodation: Full Course | 3 PartsYoga Cave - $7,230.00 USDZen Bungalow - $7,620.00 USDBeach Bungalow Standard - $7,815.00 USDBeach Bungalow Superior - $8,205.00 USDOcean Room - $8,790.00 USDI don't need accommodation - $5,500.00Accommodation: Part 1 & 2Yoga Cave - $4,820.00 USDZen Bungalow - $5,080.00 USDBeach Bungalow Standard - $5,210.00 USDBeach Bungalow Superior - $5,660.00 USDOcean Room - $5,860.00 USDI don't need accommodation - $3,650.00Accommodation: Part 3 OnlyYoga Cave - $2,780.00 USDZen Bungalow - $2,920.00 USDBeach Bungalow Standard - $2,990.00 USDBeach Bungalow Superior - $3,130.00 USDOcean Room - $3,340.00 USDI don't need accommodation - $2,150.00 USDRoom for April/May 2020 Foundation CourseYoga Cave - $900 USDZen Bungalow - $1200 USDBeach Bungalow Standard - $1200 USDBeach Bungalow Superior - $1500 USDOcean Room - $1800 USD)I don't need a room - $0.00Early Bird Discount for April/May 2020 Foundation YTT Price: -$500.00 Early Bird discount applies only if you apply and pay at least 90 days before the course starts.Early Bird Discount for May/June 2020 Foundation YTT Price: -$500.00 Early Bird discount applies only if you apply and pay at least 90 days before the course starts.Room for Sep/Oct 2020 Foundation CourseYoga Cave - $900 USDZen Bungalow - $1200 USDBeach Bungalow Standard - $1200 USDBeach Bungalow Superior - $1500 USDOcean Room - $1800 USDI don't need a room - $0.00Early Bird Discount for September 2020 Foundation YTT Price: -$500.00 Early Bird discount applies only if you apply and pay at least 90 days before the course starts.Room for Dec 2019 YIN YTTYIN YTT on Beach Bungalow Standard (All included) - $3290 USD (SOLD OUT)YIN YTT on Beach Bungalow Superior (All included) - $3500 USD (SOLD OUT)YIN YTT on Ocean Room Garden View (All included) - $3780 USD (SOLD OUT)I want more info about alternative accommodationEarly Bird Discount for Dec 2019 YIN YTT Price: -$300.00 Early Bird discount applies only if you apply and pay at least 90 days before the course starts.Rooms Availability: *All rooms for all courses are subject to availability. *Please keep in mind that the $500 USD deposit will secures your room, otherwise we cannot guarantee you’ll have the room you choose available. *After submitting your form, please wait for confirmation from our team to ensure we have availability.Universal Yoga Note: *There's 3 exams (1 for each part) for this course. Each exam have and additional cost of $100. This amount can be paid after you complete the course and it's optional.Promo CodeThanks for subscribing! Here's your discount! Price: -$100.00 Total $0.00 Personal detailsWhat languages do you speak?*What is your current occupation?*Do you have any creative talents or professional hobbies?What is your yoga history?*Please provide details of any previous YTTs you have completed and your yoga teaching experience (if applicable)Do you have any injuries or medical conditions that may that may affect your yoga practice?*CommentsTerms and conditions. Please check all of the checkboxes. By submitting this form you agree to all of the following conditions:Due to limited spaces for Vikasa YTT throughout the year a deposit is required to secure the booking. A non-refundable $500 deposit is payable at the time of booking with the remaining balance due no later than 45 days prior to start of the course.* I understand that this teacher training course will be both physically and mentally challenging, with two yoga practices daily along with up to 6 hours of required class and workshop time* I understand that cigarettes, alcohol, and illegal drugs will NOT be permitted for the duration of the training* I am also aware that yoga is a physical practice and I take full responsibility for any injuries or accidents that may occur during the retreat as a result of my doing. I take full responsibility for my own health and well-being during the course and will not hold Vikasa Yoga or any of the teaching staff responsible for injuries or other medical problems that might occur* I understand that group meals cannot be custom ordered to fit personal needs or requirements simply because personal dietary preferences and needs vary so greatly. If I have specific nutritional needs, I understand I need to make arrangements myself* I understand that the course deposit of 500 USD is non-refundable and that remaining tuition paid is 100% refundable up until 45 days before course start date, after which time, it becomes non-refundable as well* I understand that Vikasa Yoga follows the curriculum guidelines of the Yoga Alliance; and therefore, requires all participants to show up, participate, and commit 100% to the course. Students who give 100% will almost certainly graduate successfully. Those who do not may jeopardize their certification* I understand that a positive, team-oriented, optimistic attitude is a requirement for all attendees. Disruptive, rude, or negative behavior will not be tolerated and may result in removal from the course* I understand the course will be taught in english language only. All materials provided will be in english language.* I understand that early bird discount applies only if I pay the deposit 90 days or more before the course starts.Signature* This iframe contains the logic required to handle Ajax powered Gravity Forms.