Blessing/Prayer Request Form

Fill the Form Below to Submit Your Prayer/Blessing Request for the Kalpataru Yoga Program

Participants submitting a Prayer/Blessing Request as part of the Kalpataru Yoga Program understand that all blessings, instructions, initiations, teachings and suggestions made as part of the Program are purely in a spiritual capacity and are not intended to be any sort of guarantee or definitive statement about the past, present, or the future or any sort of medical advice, physical or mental.

Select the zone most applicable to you*

First Name*

Last Name*

Gender*

Male

Female

Email Address*

Phone*

Country Code

Phone Number*

Country*

State*

City*

PRAYER REQUEST

By providing my personal details such as contact details, phone number, address, email address and any other related details I provide to register as student of Kailasa Limited or its affiliates or in any other capacity, I agree to receive emails, phone calls, text messages or any other form of communication from Kailasa Limited, its affiliates, staff, volunteers and any other person in association to facilitate its services, which may include, among other things, information on other classes and programs, promotions, newsletters, inspirational messages, registration information, any other service requests and suggestions, and tips about the Vedic/Hindu tradition. I understand that a student may opt out of any such method of communication at any time by using the UNSUBSCRIBE option on emails or contacting Program Organizers.

Legal Guardian Name

Optional (Required if Minor)

First

Last

Note: For participants under the age of 18 (minor), minor’s parent/legal guardian must complete and sign this form on minor’s behalf

Signature (Legal Name)*

By Signing Below, I Am Consenting To The Use Of My Electronic Signature In Lieu Of An Original Signature On Paper.

This field should be left blank