Private Classes Booking Form

Private Classes & Counselling

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Type of Session *

Initial Series of 3 Sessions $390 Series of 3 Follow up Sessions $390 Single Follow up Session $130 Single Session $160

* we will send an invoice to you for the option selected to be paid in advance of your session/s.

Which type of session would you like? *

Professional Counselling Private Classes Personal & Professional Mentoring

Preferred days/times for your sessions. Provide a couple of options. *

Choose One *

in-person onsite (at Kookaburra Yoga) remote online (facetime, zoom, skype)

Briefly describe your issues, objectives, reasons for booking these sessions *

List relevant mental/physical health issues, injuries or focus areas *

Notes or any other information for us *

Upload any supporting documents *

Max file size: 20MB

Emergency Contact Name *

First

Last

Emergency Contact Phone *

Submit