Registration Form

Name (same as passport/ID) *

Nationality (same as passport/ID)

WhatsApp number & country code *

Email *

M / F *

Age

What is the name of the Course/Retreat you are registering for? *

What dates are you registering for? *

What is your level of skill/experience in Taichi & Qigong? Beginner, Intermediate, Advanced? *

What fitness program or health exercise to you practice regularly? *

What is your current state of health? Poor, Average, Good? *

Do you have any health issues? *

Anything else you would like to share that we should know about? *

Do you have any questions? *

I agree NOT to bring my phone or electronic devices to the practice room/area YES/NO? *

I agree NOT to smoke/vape or take illegal drugs/narcotics for the full duration of the Course/Retreat YES/NO? *

I have read and agree to all Terms & Conditions on this webpage: https://taichibali.com/terms-conditions/ YES/NO? *

Your electronic signature (write your Passport number/ID) *

Today’s Date *

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