Classes
Programs
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About
Impact
Contact
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Classes
Programs
Schedule
For Clients
For Therapists
About
Impact
Contact
Donate
Therapist Sign-In
Name
*
First Name
Last Name
Email
*
Phone
Country
(###)
###
####
Address
Home Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Programs Attending Summer 2025
BAER - June 23rd-June 26th 2025
BAES - June 23rd-June 26th 2025 SomatoEmotional Release
BAEC - June 23rd-June 26th 2025 CranioSacral Therapy
DATIP - June 30th-July 3rd 2025
BADA - July 7th-July 10th 2025
DATIP - July 14th-July 17th 2025
BAEA - July 21st-July 24th 2025 Advanced CranioSacral Therapy
BAER - July 21st-July 24th 2025 Exploration of Relationships: Shared Connections
DATIP - July 28th-July31st 2025
Emergency Contact
*
First Name
Last Name
*
Relationship to Contact
*
Emergency Contacts Phone Number
Country
(###)
###
####
Professional License Number
*
Please include professional license number as well as state/country you're licensed to practice.
Lodging
*
Please include where you will be staying for the Summer 2025 Program
Contact Info During Program
*
Please let us know if you will have an international plan/will be able to be contacted through other means (i.e whatsapp/viber/etc)
Cell Phone Number
Wifi Supported Phone Apps
Thank you!
