ADF's Parkinson's Movement Initiative: Class Registration Form
ADF's Parkinson's Movement Initiative (PMI) will offer weekly ZOOM & IN-PERSON Dance and Pilates for Parkinson's classes in FALL 2022 & WINTER/ SPRING 2023. By filling out the information below, you are registering for access to ALL CLASSES.

*Please register once per person - if you are a care partner and a mover with PD, you must each register and sign the waiver separately, even if you are planning to log in and share the same screen. *

After you submit the form, the FOLLOWING PAGE will provide class instructions and links. PLEASE READ AND SAVE these instructions and links to access upcoming classes!  Links will also be emailed once a week in case you misplace them.

For more information, visit www.americandancefestival.org
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First and Last Name (only one person - fill out twice if registering two people): *
Email Address: *
Mailing Address: *
Phone Number: *
Please provide a local emergency contact (name): *
Please provide a local emergency contact (phone number): *
Have you previously taken Parkinson's Movement Initiative classes through ADF's Scripps Studios, in person or on ZOOM? *
Have you previously taken Parkinson's Movement Initiative YouTube classes? *
Select which best describes you *
Liability Waiver and Release: As with all exercise/movement programs, when participating in online classes, you need to use common sense. To reduce and avoid injury, you will want to check with your doctor before beginning any movement program. By performing any movement exercises, you are performing them at your own risk and accept responsibility for any injury or harm you sustain as a result of our fitness/movement program, online fitness videos, or information shared on our website. This includes emails, videos, and text.
BY CHECKING "I AGREE" BELOW, I ACKNOWLEDGE THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE ALL CLAIMS OR CAUSES OF ACTION AGAINST THE AMERICAN DANCE FESTIVAL (ADF), POE WELLNESS SOLUTIONS, AND NC DANCE FOR PARKINSON'S FOR PERSONAL INJURY OR PROPERTY DAMAGE. *
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After clicking SUBMIT you will receive instructions and links ON THE FOLLOWING PAGE for how to access PMI Zoom Classes. PLEASE READ AND SAVE these instructions and links to access upcoming classes! *
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