Registration Form of interest for Dance Therapy and Somatic Coaching

By filling in this form, you are showing intrest in Individual Dance Therapy and/or Somatic Coaching

Email *
Basic Personal Information
Full Name *
Address (Street, nr., postal code, city, state, country) *
Email Address *
Phone Number (include Country Code if Relevant)  *
Date of Birth  *
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Profession *
Please tell me something about why you would like  to plan a session or ask a question. I will come back to you within a few days
What is your movement experience? 
Have you engaged with any other somatic work (e.g., yoga, dance, sports)? If yes, please provide details.
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By submitting this registration form, I agree to the processing of my personal data by  Dance and Therapy Katharina Conradi as stated in the Privacy Statement (see bottom of banner on the website)
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Required
If you want to book a first session you will be asked to bring 60 euro cash with you. if you want to continue the prices of the website will be valid.  *
Required
Do you have any comments, remarks, anything you want us to know or ask?
Thank you for your intrest in Dance Therapy and/or Somatic Coaching. I will get back to you soon. 
A copy of your responses will be emailed to .
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