Bali Yoga Teacher Training
Registration Form

If you are interested in Ki McGraw and Bob Smith’s Yoga Teacher Training Course in Bali, Indonesia, please submit the following registration form. After we receive this information, we will contact you as soon as possible with further details. A printable version of this form is also available.

If you have questions, please contact Ki or Bob at (206) 632-1443.

Name: (required)
E-mail: (required)
Phone: (required)

Address:
City:
State:
Zip Code:
Work Phone
Fax:

Date of Birth:
Education:
Occupation:
Present Employer:
Marital Status:
Number of Children:
Ages of Children:

Past Injuries and/or Surgeries:
Current Therapeutic Practices (concerning the injuries):

Yoga & Meditation Background (including key teachers):
Description of Lifestyle:

Personal Statement Regarding Participation (please use backside and add your own paper as well):

Bali House and Retreat Center for Rent

Bali Yoga Teacher Training Registration Form

Bali Yoga Teacher Training
Registration Form