Bodynamic Workshop Registration - The Healing Circle

Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Educational Background *

Current Work Position *

Do you own a business/are self-employed/are an employee? *

Do you have experience as a teacher/therapist? *

Have you participated in any personal/ professional/ therapeutic development – individually or in group for how long and which? *

What is your motivation and intention to participate in this training/ education? *

Do you already have knowledge of the Bodynamic system? *