Request edit access
Somatic Movement Introductory Class
Monday October.5th 5:00-6:15pm
Pacific Northwest Metabolic Health Collective, Cambell River 
Sign in to Google to save your progress. Learn more
Email *
IMPORTANT: To participate in this class you must be able to independently get up and down from the floor. If you cannot, but would still like to participate in Somatics, please contact me via email at angelica@integralsomatics.ca to book a private session!
NAME: *
TELEPHONE: *
ADDRESS: *
Are you new to Somatics? If no please explain. *
Have you been advised by a doctor not to exercise? If yes, please explain:
Are you dealing with any type of chronic pain, injury, or other health issues, that are affecting your ability to move? If yes please explain:
PLEASE READ ALL IMPORTANT INFORMATION BELOW : 
Payment of $30.00 is required upon registration to confirm your spot and can be made by e-transfer to: angelica@integralsomatics.ca  Please wear lose/non restrictive clothing. Bring a yoga mat, blanket, warm layers and a water bottleSee you there!
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report