GYROTONIC? / GYROKINESIS? Level I

GYROTONIC®Level 2 Prep-Course /

GYROKINESIS®Beginner Level 2 Registration Form

First Name: ______Last Name: ______

Address: ______City: ______

State: ______Zip: ______

Phone: ______Fax: ______

E-Mail: ______

Studio Affiliation: ______

Address: ______City: ______

State: ______Zip: ______

Phone: ______Fax: ______Web:______

Pre-Requisites: GYROTONIC® Level 1 certificate: ______, 200 .

Please check one.

□ GYROTONIC® Level 2 Prep-Course

Please return this form with a deposit of $100.00 check or money order payable to

MOVEMENT & BEYOND by ______, 200 .

The remaining balance of $350.00 is due the first day of the course.

Cash is also accepted.

□ GYROKINESIS®Level 2 beginner Course

Please return this form with a deposit of $200.00 check or money order payable to

MOVEMENT & BEYOND by ______, 200 .

The remaining balance of $700.00 is due the first day of the course.

Cash is also accepted.

Supplementary Provisions:

• Deposit is non-refundable if participant notifies MOVEMENT & BEYOND, INC. less than two weeks before to cancel his/her participation in this Level I Teacher Training Course.
• If Master Trainer/ MOVEMENT & BEYOND, INC, occur cancellationfull deposit will be refunded to participants.

Training Cost is non-refundable when participant has taken the training for more than 1days.

Training courses are subject to cancellation or postponement if there are less than 4 participants enrolled.

• If participant is absent from the course he /she has to make up the hours of the course with Master Trainer, and there will be an extra cost for Master Trainer’ time.

PLEASE WRITE YOUR MEDICAL / PHYSCAL HISTORY FOR THE PAST 3 YEARS:

RELEASE FORM

I recognize that the Teacher Training Courseis intended for bodywork and health

education. I understand the activities during the course may at times be strenuous

and require physical activity. Through my participation in the course, I agree to not

exceed my limits in practicing any course- related activities and to take full

responsibility for my physical fitness, and/or any injury I might suffer during the

practice. It is my responsibility to ascertain that there are no medical reasons which

prevent my participation. I assume full risk for any injuries, which may incur and

waive any claim that I might have at any time, now or in the future, for injury of any

sort, against the Master Trainer and /or MOVEMENT & BEYOND, INC. or any

person or entities in anyway involved therewith, in regards to MOVEMENT &

BEYOND, INC.

Please sign and date below that you acknowledge and agree to the above policies.

______

Participant’s Signature Date

MOVEMENT & BEYOND

73 Spring Street Suites 206. New York, NY 10012

Phone: 646-613-8086/917-951-7971 Fax: 646-613-8090 E-mail:

GYROTONIC®andGYROKINESIS®are trademarks of GYROTONIC®Sales Inc, New York, NY. USA and used with their permission.