*Mission Improvable 2024*
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first name and last name *
phone number *
email *
Briefly write why you would like to attend this workshop.
preferred pronouns
Do you need to be hosted? *
Do you have any dietary needs? *
Can you arrive on Wednesday, April 10 by 6:00 pm? Can you stay till 6:00 pm on Sunday, April 14 for performance and strike?
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Fees - Internships and Scholarships - can check all that apply
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Required
There is no refund. You can use your money for upcoming Mission Improvable events as well as Center Mouvement events. Email Nancy at nfhughes@gmail.com with questions.
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Mission Improvable
Center Mouvement
Liability Release Form
I understand that there are risks of physical injury associated with, arising out of and
inherent to the activity of contact improvisation. In recognition of this acknowledged risk
of injury, I knowingly and voluntarily waive all right and/or causes of action of any kind,
including any and all claims of negligence arising as a result of such activity from which
liability could accrue to Center Mouvement, agents, employees, instructors,
and all affiliated entities, as well as to St. John’s Grace.
I hereby agree to release Center Mouvement, St. John’s Grace and hold Center Mouvement, St. John’s Grace harmless of all liability, and hereby acknowledge that I knowingly and voluntarily assume full responsibility for all risks of physical injury arising out of active participation in contact improvisation on behalf of the participant. I am aware that this is a release of liability and an acknowledgement of my voluntary and knowing assumption of the risk of injury. I have signed this document voluntarily and of my own free will in exchange for the privilege of participation.

I give consent for recorded images of me taken at this event to be
used for any and all purposes, including advertising or trade activities such as promotion
of future contact improvisation events.
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payment:   https://clients.mindbodyonline.com/classic/ws?studioid=502248&stype=-102&sTG=25&sVT=30&sView=day&sLoc=0 *
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