Name (required) *

E-Mail (required) *

Telephone

I understand that Feldenkrais® is not a medical treatment, but movement explorations designed to help me find easier ways to do familiar activities. *YesNo

I give permission to the Feldenkrais® teacher to lead me through movement sequences that comprise the Feldenkrais Method® *YesNo

I welcome communications between the teacher and me, insofar as appropriate to help me adjust my comfort or otherwise correct my position for optimal benefit from the class *YesNo

I understand and agree that I am responsible for my own well-being while doing Feldenkrais® *YesNo

I plan to follow the Feldenkrais® teaching to do small movements in a deliberate fashion. If I begin to experience any discomfort, I will do still smaller movements, even more slowly.
 If even the smallest movement is uncomfortable, I will only imagine doing the movement, instead of actually doing it. *YesNo

I understand that I would have prior permission to consent or decline any recording or photographs of me engaging in these lessons. *YesNo

Your notes / requests