Stretch What Matters, LLC 200 Hour Application 25 Pearl Street Natick, MA 01760
Name:______
Address: ______
Home Phone: ______Work Phone______Email______
Occupation______
Employer ______
Emergency Contact Name: ______
Emergency Contact Phone ______
Physician______Telephone______
Hello,
I am honored to share this training with you! It is my intention to support you and those you teach fully. The information you provide will allow me to best support you. Please answer each of the following questions thoughtfully and thoroughly.
I understand that everyone is in a different place with teaching yoga. Some of you may have begun sharing this work following the Level 1, Foundations Course, while others may be planning to do so after the completion of the 200-hour. We are all going at a pace that is comfortable for each of us.
Warmly,
Elizabeth Answer the following questions on a separate sheet
1. What does your own yoga and meditation practice look like at this time?
2. How have you implemented the information you learned from the Level 1, Foundations training into your own life?
3. If applicable, how have you implemented the information you learned from the Level 1/Foundations training with others? Please share who you teach, how often and how you believe your yoga services are working for those you teach (in your home, school, yoga studio, therapeutic office, etc).
4. If you have a profile in mind that you wish to serve, please list the details. Include age range, diagnostic label(s) and class-size (inclusive, small, 1:1, family). If you are unsure, please let me know that too.
5. If applicable, reflect on the components of a yoga class (see Level 1 manual) and identify the areas you feel the most/least confident.
6. What skills are you intending to solidify during the 200-hour teacher training?
7. Create a personal intention statement. Share why the yoga practice speaks to you, what your vision for the 200 hour training is and how you plan to share what you learn with those with special needs.
8. Have you had any serious illnesses, surgeries, or procedures within the last 3 years?
9. Is there any thing else you would like to let me know?
Declaration of Disclosure and Acceptance of Terms
Awareness is fundamental to the practice of Yoga. As a student, it is solely your responsibility to monitor each activity offered and determine whether it is appropriate to participate. You remain primarily responsible for your safety and well-being.
Please read and sign: I have enrolled in a teacher-training program of physical activity, including but not limited to various yoga, meditation and breathing exercises offered by Stretch What Matters, LLC. I release Elizabeth Goranson, and Stretch What Matters, LLC, as well as any teachers or assistants involved in any way in the offering or the provision of this Teaching Program, from any liability now, or in future for injury, however caused, occurring during or after my participation in this program. I agree to practice yoga at least once/week beginning now in an effort to consciously prepare my mind and body.
I agree to acknowledge that I have completed a Stretch What Matters 200 hour training. I agree that the information contained in my training manual, given to me during this training is copyrighted information and as such is not to be copied without written instruction from Elizabeth Goranson and the 200 hour faculty members.
I also agree, as a representative of Stretch What Matters Yoga, that my intention is to treat individuals with special needs with the highest amount of care, respect and love.
Signed______Date______
Name Printed ______
Terms and Conditions: Tuition: Non-refundable deposit to reserve your space: $500
Early bird tuition, due June 1, 2015: $3,100 (minus $500 deposit if previously submitted)
Regular tuition, due September 1, 2015: $3,400 (minus $500 deposit if already submitted)
Payment plan option: $3,400 A credit card must be provided for payment plan option and the card will be charged automatically if check or cash are not provided on schedule. A five- month plan would essentially come down to a $500 deposit plus six payments of $500. First payment would be due on or before May 1, 2015. Subsequent payments are due on the first of each month beginning in September (September, October, November, December, January and February ($400 in February)).
To confirm your reservation, please email the completed registration forms and make a full payment or a minimum non-refundable and non-transferable deposit of $500. Payment holds your spot.
If paying by check, make checks payable to Stretch What Matters, LLC. Mail your payment to Stretch What Matters, LLC at 25 Pearl Street, Natick, MA 01760.
All payments made are non-refundable, unless the program is canceled by Stretch What Matters, LLC, in which event you will receive a full refund. However Stretch What Matters, LLC shall not be responsible for refunding airline tickets or hotels under any circumstances.
If registrant cancels 15 or more days before the program start date, by way of Stretch What Matters, LLC receiving notice from registrant within that time, the sum of $50 shall be deducted by Stretch What Matters, LLC as an expense of administration and registrant’s remaining balance will be refunded. Once the program has begun, tuition is non-refundable.
Program Requirements and Attendance:
Registrant understands that after paying in full and fulfilling the requirements from the Stretch What Matters 200 hour Yoga Teacher Training, which includes in-class hours, homework, quizzes and passing both the written and in-class final exams, registrant will receive a certificate of completion.
Make up hours are the responsibility of the registrant and must be approved subject material by Stretch What Matters. If registrant needs to make up hours with a Lead Teacher, this will be an additional cost outside of program costs ($100 per hour).
By signing below, I, the registrant, agree to these terms and conditions.
Signature:______Date:______