Application Form for Biodanza IBFed, East Coast-USA Facilitator Training Program-Maryland/DC-USA 
This is the formal application form for the East Coast IBFed sanctioned facilitator training from whom you will receive your certificate upon completion. Biodanza Maryland/DC is a member of the IBFed A.T.E.S. Biodanza Association (comprised of 6 schools worldwide) which meets regularly. 
Email *
                       Biodanza USA, poetry of human encounter 
First and Last Name/Nickname   *
Full address:street/city/state/zip *
Cell phone number  *
What languages do you speak other than English?  *
Emergency contact, (first and last name) and cell number and email of a friend/family member.  *
If you have any emotional issues/diagnoses or health issues/life medications that I should know about in order to better care for you during the training, please mention them below.  
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What is your preferred email address for Biodanza correspondence? *
How did you find out about this program?  *
How many years of Biodanza experience do you have?  Who was your teacher(s). Where? How many hours (approximately) of Biodanza have you done? How do you know Biodanza? Please include any workshops or encounters you have attended with month/year.  Explain in detail below.  50 hours are needed to begin the program, but those with none, do not worry as it's the first school on the East Coast and Biodanza is quite new in the USA with few facilitators.  You will be the pioneers who will deliver it to the country.  Attending a weekly class is also a requirement.  If you live far away, attempting to attend one a month or go to a weekend workshop is essential for your growth in Biodanza.  *
Have you done all or part of a Biodanza school elsewhere? With what director?  Include director's email.  Include a list of all modules completed with month and year completed.  You will be required to redo the modules to ensure cohesion of the program/students, but at half price.   *
What is/have been your professions in your life?   *
What other degree or certifications do you possess?  *
Why do you want to do the 28 weekend Biodanza training course which will be held in English?  Be thoughtful and specific giving examples examples.  Please use paragraphs for easier reading.   *
The future 2024/2025 dates are on the website.

Please mark these dates and indicate below if you absolutely cannot attend a weekend due to a wedding or some other uber important event.  If you do miss a weekend, you will need to make it up either in another school or in the make-up weekend that will be organized during a summer month.  

Please make any comments necessary below. 
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Biodanza is a drug and alcohol free zone.  Please do not bring substances to our weekend events.  Please leave a message below stating you understand this policy. *

BIODANZA DANCE CLASS LIABILITY WAIVER

Participant Release and Waiver of Liability

I, ______________________________ (First Name) ______________________________ (Last Name), acknowledge that I have voluntarily chosen to participate in the Biodanza dance class. I understand that this class involves movement, dancing solo, in pairs, and in groups, and may include physical contact such as holding hands or other gentle touch.

I acknowledge and agree to the following:

Assumption of Risk: I am aware that participating in any physical activity, including dance, carries inherent risks, including but not limited to physical injury, muscle strain, or emotional discomfort. I assume full responsibility for any risks, injuries, or damages, known or unknown, which may occur as a result of my participation. 
Health and Physical Condition: I confirm that I am in good health and have no medical conditions that would prevent my safe participation in this class. I understand it is my responsibility to inform the facilitator of any relevant health concerns before participating. 
Release of Liability: I hereby release, waive, and discharge the Biodanza facilitator, class organizers, venue owners, and rental space from any and all liability, claims, demands, actions, or causes of action arising from any injuries, damages, or losses I may experience in connection with my participation in the class. Personal Responsibility: I understand that I am responsible for my own well-being and participation. I agree to listen to my body, engage in the activities at a level that feels safe for me, and respect my own boundaries as well as those of others. 
Photography and Media Release (Optional): I consent to the use of any photographs or video recordings taken during the class for promotional or educational purposes. (If you do not consent, please state this below in area provided. 
Agreement to Terms: By signing below, I affirm that I have read, understand, and voluntarily agree to this waiver. I understand that this document is legally binding and applies to my participation in any and all Biodanza classes facilitated at this venue.

PLEASE SING BELOW stating you understand the policy. 
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I am so pleased to be offering this IBFed Biodanza Training for you in the Maryland/DC Facilitator training. 

Sending you much love and extending you a big Biodanza hug.  Let's make this world a better place to live offering Biodanza to the world! 

I will review your application and call you and will respond to your application with an email letter within a week after our phone call.  

Feel free to leave me any messages below.


Peace
Michelle Dubreuil
Biodanza Director- Biodanza Maryland/DC School
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