AZ Dance Medicine Specialists - Workshop Request
Interested in a workshop or seminar for your students or staff?  Simply complete our request form and let us know what you're looking for and we will be in touch to schedule a call or video session to discuss details.

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CONTACT INFO
Name *
Studio Name *
Studio Address *
Owner/Director *
Email *
Phone *
REQUESTED SERVICES
Which services would you like from AZDM? (I = Instructor Session, S = Student Session)
For Students
For Instructors
Talking About Nutrition WITHOUT Talking About Food (I/S)
Increasing Flexibility When Stretching DOESN'T Work (I/S)
Improving Your Foot Pointe and Arabesque WITHOUT Stretching (S)
Hidden Signs of Core Weakness in Dance (I/S)
Concepts in Movement Analysis and Functional Assessment (I)
Anatomy and Kinesiology That MATTERS (I)
Q&A "Brain Picking" Session (I)
Injury Prevention Screening
Pointe Readiness Screening
Private Sessions
Approximate number of students (type "NA" if just interested in instructor sessions) *
Approximate number of instructors (type "NA" if just interested in student sessions) *
EQUIPMENT
Let us know if you have the following (nothing is required, it just helps us know what to bring) *
Yes
No
Projection screen
Blank wall for projection
Yoga mats
Tumbling mats
Any Questions?  Ask them here to get started, but details will be covered in future communications.
DATES AND TERMS
All dates will be confirmed on a first come first serve basis upon receipt of $300 deposit.  Your deposit will reserve your chosen day, cover supplies, and admin fees.  Class session fees are due on day of service.  AZDM accepts cashier's checks, money order,  and all major credit cards. We will do everything we can to make sure everyone gets what they requested : )  You will receive an invoice for the deposit amount upon submission of this form.  Deposit is refundable up to 10 business days before intended event date.
Dates Requested
I have read the dates, terms and fees and understand that deposit is required to confirm services. *
SIGNATURE
Full name
Date
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Time
Time
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