Rebirth - The Spring Dream Dance Ceremony

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Dear Dancer,

This form is for members of the public wishing to join us at Spring Dream Dance so we can find out bit more about you.

We will not share your personal information with any third party outside The School of Movement Medicine.

If you require further information please email hello@schoolofmm.com

Email *

Record my email address with my response

Email address

First name

Surname

Date of birth

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How would you describe your gender?

(for rooming purposes)

Male (including transgender men)

Female (including transgender women)

Prefer not to say

Other:

Please tell us what previous experience you have had of Movement Medicine? *

If you have no experience with Movement Medicine please tell us about your previous experience of this kind of work. *

Please be kind enough to let us know if you are on any medication or have previous challenges with your mental health that would affect your participation?
*

Is there anything you would like to tell us about you at this time of your life? *

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