Himalayan Yoga and Meditation Center Registration Form

Fill out the registration form and click submit button to email it to us. You can print this page for your records.

Registration Form
Name
Address
City, State, & Zip
Phone Home 
Work  
E-Mail Address
Class / Workshop
(Code/Day/Time/Instructor-see class schedule)
 
 
 
  First-time Student
Where did you hear about us?
.........................................................................................................................
Refer friends & family members
.........................................................................................................................
You will receive a confirmation via E-Mail. We will call you only if the class for which you are registering is full. -(Please see the Class Schedule for fees)

Please send payment to:
Himalayan Yoga and Meditation Center
109 W Slade St , Palatine, IL 60067
Telephone: (847) 221-5250