IMMERSION REGISTRATION FORM

Please fill out the following to register for the immersion

First Name

Last Name

Address

Phone

What type of movement practice do you currently teach? (Ex. Hot yoga, Inner Axis, I’m a personal trainer, massage therapist, etc.)

How many hours a week do you teach, or work with clients?

What area of your work with students and clients do you feel you really excel in?

What area of your work with students and clients do you feel you need help with? (Ex. verbal cues, dealing with injuries, working with different personalities, etc.)

Do you currently have a physical issue that is limiting your movement or exercise routine? Please explain.

Do you have specific goals for your teaching/business? (Ex. having your own studio, becoming a teacher trainer, becoming a physical therapist, working with children - please share as much as you like)

Why do you teach/work with clients?

Why are you attending this continued education immersion?

Do you have any specific goals around what you’d like to learn in this immersion?

Please share anything else you feel is important for me to know about you, your body or your goals.

Thank you for your submission! Click here to download a copy of this form.

Yoga . Fitness . Pilates . Movement Therapy . Posture

Movement Therapy Company

IMMERSION REGISTRATION FORM

Please fill out the following to register for the immersion

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