Private Yoga Instruction Booking Private Yoga Instruction Booking Thanks for your interest in private individual or group yoga sessions! Please submit the completed form and Danielle will contact you shortly to schedule your upcoming session. Name* First Last Email* Enter Email Confirm Email Phone*Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country If visiting Maui, where on the island are you staying?Please list name of condo or hotel if applicable.How did you hear about us?*Please describe your yoga experience as well as any injuries or special requests for your practice.*Do you need yoga mats for your class?*YesNo1.25 Hour Private Individual and Group Classes for up to 4 students.*Single Session ($95/class)Two Sessions ($95/class)3 Class Series ($90/class)5 Class Series ($85/class)10 Class Series ($80/class)Total number of students participating in the private yoga session. (The private class price includes up to 4 students. Each additional student who joins the class is $18 per person per class.)*1 Student2 Students3 Students4 Students5 Students6 Students7 Students8 StudentsTotal number of students participating in the private yoga session. (The private class price includes up to 4 students. Each additional student who joins the class is $18 per person per class.)*1 Student2 Students3 Students4 Students5 Students6 Students7 Students8 StudentsTotal number of students participating in the private yoga session. (The private class price includes up to 4 students. Each additional student who joins the class is $18 per person per class.)*1 Student2 Students3 Students4 Students5 Students6 Students7 Students8 StudentsTotal number of students participating in the private yoga session. (The private class price includes up to 4 students. Each additional student who joins the class is $18 per person per class.)*1 Student2 Students3 Students4 Students5 Students6 Students7 Students8 StudentsTotal number of students participating in the private yoga session. (The private class price includes up to 4 students. Each additional student who joins the class is $18 per person per class.)*1 Student2 Students3 Students4 Students5 Students6 Students7 Students8 StudentsIsland Location for Travel Fee*I am happy to come to your residence or accommodation for your private yoga session(s), and I do charge a travel fee depending on location. To accurately price your sessions, please indicate where on the island you are located.South Side (Kihei, Wailea, Makena, Maalaea)West Side (Lahaina, Kaanapali, Olowalu, Launiupoko, Napili, Kapalua)North Shore (Paia, Kuau, Spreckelsville, Haiku)Central Valley (Kahului, Wailuku, Waikapu, Waihee)Upcountry (Makawao, Kula, Pukalani, Haliimaile)Island Location for Travel Fee*I am happy to come to your residence or accommodation for your private yoga session(s), and I do charge a travel fee depending on location. To accurately price your sessions, please indicate where on the island you are located.South Side - $50/day (Kihei, Wailea, Makena, Maalaea)West Side - $100/day (Lahaina, Kaanapali, Olowalu, Launiupoko, Napili, Kapalua)North Shore - $25/day (Paia, Kuau, Spreckelsville, Haiku)Central Valley - $25/day (Kahului, Wailuku, Waikapu, Waihee)Upcountry - no charge (Makawao, Kula, Pukalani, Haliimaile)Island Location for Travel Fee*I am happy to come to your residence or accommodation for your private yoga session(s), and I do charge a travel fee depending on location. To accurately price your sessions, please indicate where on the island you are located.South Side - $50/day (Kihei, Wailea, Makena, Maalaea)West Side - $100/day (Lahaina, Kaanapali, Olowalu, Launiupoko, Napili, Kapalua)North Shore - $25/day (Paia, Kuau, Spreckelsville, Haiku)Central Valley - $25/day (Kahului, Wailuku, Waikapu, Waihee)Upcountry - no charge (Makawao, Kula, Pukalani, Haliimaile)Island Location for Travel Fee*I am happy to come to your residence or accommodation for your private yoga session(s), and I do charge a travel fee depending on location. To accurately price your sessions, please indicate where on the island you are located.South Side - $50/day (Kihei, Wailea, Makena, Maalaea)West Side - $100/day (Lahaina, Kaanapali, Olowalu, Launiupoko, Napili, Kapalua)North Shore - $25/day (Paia, Kuau, Spreckelsville, Haiku)Central Valley - $25/day (Kahului, Wailuku, Waikapu, Waihee)Upcountry - no charge (Makawao, Kula, Pukalani, Haliimaile)Island Location for Travel Fee*I am happy to come to your residence or accommodation for your private yoga session(s), and I do charge a travel fee depending on location. To accurately price your sessions, please indicate where on the island you are located.South Side - $50/day (Kihei, Wailea, Makena, Maalaea)West Side - $100/day (Lahaina, Kaanapali, Olowalu, Launiupoko, Napili, Kapalua)North Shore - $25/day (Paia, Kuau, Spreckelsville, Haiku)Central Valley - $25/day (Kahului, Wailuku, Waikapu, Waihee)Upcountry - no charge (Makawao, Kula, Pukalani, Haliimaile)What dates, days of the week, and/or times of day work best for you?*Total $0.00 Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20182019202020212022202320242025202620272028202920302031203220332034203520362037 Expiration Date Security Code Cardholder Name
