Our Registration Form

SEVENTH CHAKRA YOGA
Kundalini Yoga Teacher Training Level 1 2017- 2018
Registration - Payment - Agreements
Name: ___________________________________________Date_____________
Phones: H___________________________ Cell:_________________________
Address: __________________________________________________________
__________________________________D.O.B.__________________________
Email: ____________________________________________________________
Course Fee Schedule
Please circle one of the four choices and indicate payment method below.
Agreement date
Pre-Registration
Paid on or Before
August 26
Regular Registration
Paid After
August 26
Payment in Full
Payment plan
(Deposit + 7 payments)
$3,400
$3,600
Deposit of $800 and
7 installments of $400
$3,600
$3,800
Deposit of $1000 and
7 installments of $400
PAYMENT:
Cash, Check, Visa and Master Cards are all acceptable forms of payment.
If a Payment Plan is chosen, it is your responsibility to make sure that Seventh Chakra Yoga has your
Current credit or debit card on file for automatic charge of due installment. Below is the installment
due date schedule
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Kundalini Yoga Teacher Training Level 1 2017-2018
Registration – Payment - Agreements
Payment Schedule
Payment #
Payment Date
Down Payment
Amount of
payment
(circle one)
Form of
payment
$800 before
8/26 $1000
after 8/26
to hold space
Installment 1
September 23
$400
Installment 2
October 28
$400
Installment 3
November 18
$400
Installment 4
December 16
$400
Installment 5
January 13
$400
Installment 6
February 17
$400
Installment 7
March 17
$400
• A fee of $35 will be charged for any late payments, declined credit card auto payments,
or returned checks.
I, ________________________________________, authorize Seventh Chakra Yoga to charge my credit
card provided on file, for the monthly installment amounts listed above, on the scheduled dates, for
payment of Kundalini Yoga Teacher Training Level 1. I understand and agree that full, on-time
payment is one of the requirements for certification and completion of this course, and understand
and agree to the cancellation and late payment policy below.
Cancellation/Withdrawal Policy:
• All cancellations must be made in writing, and be dated and received by Priya Jain, Studio
Owner and Course Director.
• Withdrawal from the program will not be considered confirmed until a written request is
received. The date the written notice is received is the earliest date that the withdrawal will
be in effect.
• Withdrawals prior to the first day of the course will be eligible for a refund
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less $200 administration fee.
• For withdrawals after the start of the course, please review the refund cancellation policy
schedule below for attendees who have paid in full:
o After weekend #1 (Sept) $ 2,410
o After weekend #2 (Oct) $ 1,975
o After weekend #3 (Nov) $ 1,540
o After weekend #4 (Dec) $ 1,105
o After weekend #5 (Jan) $ 670
o After weekend #6 (Feb) $ 235
• There will be no refunds given for withdrawal after the 7th weekend of the
course.
• Students on a payment plan are not eligible for any refund once the course has begun.
The payment plan will be cancelled for any future dates, and the student will be responsible
to complete any payments owed.
• All paid fees may be applied within 2 years to future Level 1 Teacher Training courses with
payment of an additional $350 administrative fee.
•
Course Certification:
•
The Kundalini Research Institute (KRI) and the KRI Teacher Training team at Seventh
Chakra Yoga reserve the right to grant KRI Level One certification based solely on
their discretion and evaluation of each student’s readiness to be a Kundalini Yoga
instructor at the end of the course.
•
Attendance is one of the key requirements for certification. If more than two
weekends, or the equivalent of four days of course class time is missed, then the
student will not be eligible for certification. If less than four days of class time is
missed, then the appropriate make-up work must be completed to be eligible for
certification.
•
All paid fees and requirements completed may be applied within 2 years to future
Teacher Training courses at Seventh Chakra Yoga only, with an additional $350 reactivation fee. After the 2 year grace period the student is required to begin the
course again in order to pursue certification.
I have read, understand and agree to the policies above regarding payment, late payment,
withdrawal and refunds.
I have read, understand and agree to the policies above regarding cancellation, late
payment, and course certification.
Applicant name: __________________________________Date _____________
Applicant signature: ______________________________________________
Signature of Registrar _____________________________________________
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