Forging Understanding, Communication & Kinship in the The Space Between Us 2023

A workshop for couples with Ya’Acov and Susannah Darling Khan.

APPLICATION FORM

Please complete this application form as fully as possible. Please note that this information is only seen by those involved in running this workshop and will not be disclosed to any third party. Difficult history will not necessarily disbar you from taking part in a workshop


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Please wait to receive an email from us before purchasing a ticket through our booking system. If a ticket is purchased before an application is accepted, a refund will be issued along with an administration fee. 
Person 1- Full Name
Person 1- Date of birth
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Person 1 - Gender
Person 2 - Full Name
Person 2 - Gender
Person 2 - Date of birth
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Address
Address of person 2 if different from person 1
Person 1 - Contact number
Person 2 - Contact number
Person 1 - Email
Person 2 - Email
PERSON 1- PREREQUISITES: Please list any relevant workshops or studies that you feel make you eligible for this workshop.
PRESON 2- PREREQUISITES: Please list any relevant workshops or studies that you feel make you eligible for this workshop.
How long have you been together as a couple?

Person 1- How would you describe the current condition of your relationship? 

Please include what you can celebrate and what you see as the current challenges your relationship faces. This question is about you, not how you see your partner.


Person 2- How would you describe the current condition of your relationship? 

Please include what you can celebrate and what you see as the current challenges your relationship faces. This question is about you, not how you see your partner.


Person 1- If this workshop was a total success, what would you have acknowledged, changed, and evolved inside yourself to make that so?
Person 2- If this workshop was a total success, what would you have acknowledged, changed, and evolved inside yourself to make that so?

Person 1- Again, if this workshop was a total success, what would you have changed in terms of how you communicate and act towards your partner?


Person 2- Again, if this workshop was a total success, what would you have changed in terms of how you communicate and act towards your partner?


Person 1- Are you currently taking any medication that will influence your participation in a workshop?


Person 2- Are you currently taking any medication that will influence your participation in a workshop?

Person 1- Please disclose any illnesses or impairments that might be relevant to your studies, and indicate the adjustments that would assist you.    


Person 2- Please disclose any illnesses or impairments that might be relevant to your studies, and indicate the adjustments that would assist you.    
Person 1- The meals are being prepared by the fantastic Sandy and Steve from Dartmoor Larder and are vegan and gluten free. Our capacity to cater for individual diets is limited. Do you have any specific food needs or allergies that would not be provided for in this diet? Please specify. There will be an additional charge for special diets. Please note: If you need a special diet you MUST tell us at the time of applying, and make sure that we reply to you so that you know that it is OK. You will NOT be able to arrange a special diet once the course begins. 
Person 2- The meals are being prepared by the fantastic Sandy and Steve from Dartmoor Larder and are vegan and gluten free. Our capacity to cater for individual diets is limited. Do you have any specific food needs or allergies that would not be provided for in this diet? Please specify. There will be an additional charge for special diets. Please note: If you need a special diet you MUST tell us at the time of applying, and make sure that we reply to you so that you know that it is OK. You will NOT be able to arrange a special diet once the course begins. 

Person 1- Anything else you would like us to know about you at this time in your life?

Person 2- Anything else you would like us to know about you at this time in your life?

BOOKING CONDITIONS  

This agreement is between yourself and the School of Movement Medicine.

Please note our booking conditions as these constitute the contract between us.  

1. Payment Terms

Payment: Payments should be made in accordance with the attached payment schedule. Should any amounts not be paid by the due date, we reserve the right to treat the booking as being cancelled and charge a cancellation fee as set out in paragraph 6.   

2. The Contract

The contract to provide the workshop shall be created upon our acceptance of your booking when an invoice will be issued to you. 

3. What is included/excluded?

Included: Tuition by Susannah and Ya’Acov Darling Khan on all the advertised days of the workshop and all food and dormitory accommodation.  Excluded: Any fees for special diets or travel costs.

4. Alterations

Where the arrangements and/or facilities such as the venue or the teacher are cancelled by a third party, we will use all reasonable endeavours to provide a suitable alternative, but we are not obliged and cannot guarantee to do so. 

5. Changes to Arrangement

Every reasonable effort will be made by us to adhere to the advertised arrangements and confirmed workshop arrangements, but we reserve the right to alter/omit those arrangements should it be found necessary to do so and we shall have no liability whatsoever to you for any such changes, save the refund of any monies not expended.

6. Cancellation

Due to the many unknowns caused by Covid-19, in order to offer these intensives, our policy has changed. Please read them carefully. 

No refunds will be given from 60 days before the workshop unless your place can be filled. If any client wishes to cancel arrangements for whatever reason, the following cancellation charges shall apply: up to 60 days prior to the workshop there is a cancellation charge of £250. Within 60 days of the start of the workshop you will be liable for the total cost of the cost of the course. You are liable for the total cost of the course once it has begun.

If the participants on the booking forms need to cancel the booking once it has been confirmed, we must be notified via email only. The date on which written notification is received will determine the level of cancellation charges applicable.

7. Liability

We do not accept any liability for any matter beyond our control and we will not in any circumstances be responsible for any consequential or indirect loss that you or any third party may incur such as travel or accommodation costs if a course is cancelled.

8. Assignment

We reserve the right to assign the arrangements between us upon giving you notice in writing.

9. Accident/Injury

You need to ensure that you are of a sufficient standard of fitness and ability to partake in the workshop. Please speak to us if you are unsure about this. We will not be responsible for any accident or injury (save where it can be shown it results from our negligence) and you should take out your own insurance to cover this.  

10. Loss/theft

We cannot accept any responsibility for loss or theft of property or valuables whilst you attend the workshop.

11. Governing Law

The contract between us will be governed by the laws of England.


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PERSON 1 - By signing this document you are agreeing and accepting the Booking Conditions pertaining to this workshop.

Please date and print name below.
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PERSON 2- By signing this document you are agreeing and accepting the Booking Conditions pertaining to this workshop.

Please date and print name below
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