亞洲區 遠距線上教學 95小時 Part 1 特殊兒童瑜伽師資培訓 Registration Form - Yoga for the Special Child 95H Certification Program - Part 1 - April 8-10/15-17/21-23, 2023
Please fill in all fields
Sign in to Google to save your progress. Learn more
Email *
Where did you hear from our program? 請問您從哪個管道得知課程訊息的，國家/網站/粉絲專頁/老師 *
First Name 名字 *
Last Name 姓氏 *
Type your full name EXACTLY how you want it to appear on the Certificate/Credit Hours (whichever applies) 請填寫您證照上的中英文名字拼音 - 請註明您想要請註明您想要證照名字欄位的呈現方式。 *
We will copy and paste from here, so please write capitals and lower case letters the way you want it to be printed on credit hours. Please be diligent here!  Thanks!
Email *
Birth Date 生日 *
Occupation 職業 *
Gender 性別 *
Country 國家 *
Phone 電話 *
Hatha Yoga Level 瑜伽基礎 *
Do you have a child that is physically challenged? 請問您的孩子是帶著身心障慢飛天使的孩子嗎?           *
 ""Yes/No  (if yes, please explain below) 是/否 (若"是請提供孩子的狀況)    
Address 住址 *
Please include: Full address, city & zip 請填寫完整的住址與郵遞區號
I am aware this is a live streaming program and I will organize my schedule to be available at dates and times of training. Friday 07:00-10:00pm, Saturday and Sunday 07-09:30am and 07-10:00pm (Taiwan Standard Time)　我清楚知道這是一堂線上直播課程，我會調整我的時間在課程安排的時間準時上線上課。  
課程時間:
每周末 ~ 台灣區時間 TST (GMT+8) -          
星期五: 7:00-10:00pm          
星期六 and 星期日: 07-9:30am and 07-10:00pm *
 I am aware of the dates for the program from April 08-10, 15-17/21-23, 2022 *
By registering for this program I agree not to copy materials, share videos or any links that are shared with me by Yoga For The Special Child®, LLC.  I understand that these are copyrighted materials and are shared with me as a registered program participant at the sole discretion of Yoga  For The Special Child. Please sign your name below to acknowledge that you will NOT share the materials. 本人承諾報名此課程後，不會複製任何由「特殊兒童瑜伽」(Yoga For The Special Child®, LLC.)所提供之教材，或未經許可分享影音檔案、連結予他人。我理解「特殊兒童瑜伽」(Yoga For The Special Child®, LLC.)所提供之教材皆受著作權法保障，僅限報名課程者上課使用。敬請於以下簽名，確認您已知悉不得分享任何上課教材、影音，或課程連結予他人。 *
Emergency contact 緊急聯絡人 *
Please fill in name & number of contact 請留下全名/電話
Do you need the program to be translated to Chinese) 是否需要英文翻譯 *
What is your level of English? 英文聽力程度 *
 請問您之前是否有上過特殊兒童瑜珈的課程?   若是有，請提供地點與上課時間 Have you attended a Yoga for the Special Child Program before? If you have attended, please state where & when? *
Program tuition (please contact your program coordinator to arrange payment) 線上課程費用與方案 (名額有限)  (麻煩請與當地主辦單位聯繫付款方式) *
The teacher training experience can be a time of deep emotional connection for some people. Though this process is healing, it can also be stressful. If you have any history of mental illness i.e. depression, anxiety, schizophrenia, bipolar disorder, post-traumatic stress disorder or any form of psychosis, it would be very helpful for your teacher to know in order to be sensitive to your needs. If you are taking medications or have been hospitalized for any of these conditions please describe below. 本師資學習過程可能會讓某些學員喚起內心最深層的自己，引發一些情緒上的起伏。　這過程可能會造成學員短暫情緒上的衝擊與負擔，但是這感受是療癒自我的過程。　假如您過去有過精神上疾病的，如抑鬱症，焦慮症，精神分裂症，躁鬱症，創傷後心理壓力緊張症候群，或任何精神上的症狀，請事前告知老師及主辦單位以便老師及主辦單位能夠避免一些不必要的刺激與傷害。　倘若您有在服用任何藥物或曾經因精神疾病入院觀察，請麻煩在下方提供我們相關資訊。 *
Please list any prescription medications 是否有服用任何藥物？請提供藥物名稱。 *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms