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Illuminate - Registration
Event Timing: November 8-10, 2019
Event Address: TaoSatva, #2 Upper Las Colonias, El Prado, NM
Contact us at (575) 737-8005 or
info@moveandbemoved.net
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Name
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Email
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What 5Rhythms or other conscious dance practice do you have? Please include the names of the teachers you have worked with.
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What other forms of meditation, movement or art practice do you have?
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Who is your emergency contact? Please include name, phone number, and physical address.
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Please acknowledge the following workshop agreements:
I understand that I must attend all workshop modules.
I agree to be on time for each session.
For the strength and safety of the container, I agree to maintain confidentiality about other people's experiences.
For the strength and safety of all participants, I agree to allow others thier own process and I won't interfere.
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Agreement of Release and Waiver of Liability That I am participating in this workshop offered by Mystery in Motion & Visudha de los Santos during which I will move my body, and receive instruction and guidance about movement as meditative practice. I recognize that dance movement requires physical exertion, which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved. I represent and fully warrant that I am physically fit and I have not medical conditions that would prevent my participation in classes and workshops. I further hold Mystery in Motion & Visudha de los Santos harmless from any indemnity. By checking the box below I agree to this release and waiver of liability.
Yes I agree.
I understand that I will go to
www.paypal.com
to pay my fee electronically ($195 Standard, 0r $165 early by October 20th.) , or mail payment to PO Box 2686, Taos, NM 87571
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Yes, I will pay electronically through Paypal to
info@moveandbemoved.net
Yes, I will mail my payment
I wish to make other arrangements
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