Consent for massage workshop

Consent Form for Massage workshop

This registration and consent form is for the upcoming workshop "How Trauma-Informed Principles Can Apply To Massage Therapists And Bodyworkers" with Kelcy McNamara of ROOTS trauma sensitive yoga LLC based in southern Maine. By printing my name I understand that its acts as my signature. Your information is never shared with any other business, organization or third party. The information collected is solely for Kelcy McNamara of ROOTS trauma sensitive yoga LLC.

Name

First Name

Last Name

Phone

(###)

###

####

I am coming to this workshop as (ex. yoga instructor, yoga practitioner, clinician, therapist, massage therapist, community member etc.)

I understand that upon completion of this half day workshop I have information to make my practice a more trauma informed space for survivors, however I understand the scope of my practice and will use this information within that scope. Please sign and date:

I am physically sound to proceed with the participation of yoga or other embodiment practices. I declare myself to be responsible for my own health and safety while participating in class. I understand the importance of keeping my teachers informed of any health concerns. I agree to release Kelcy McNamara RYT/TCTSY-F, ROOTS trauma sensitive yoga LLC from any liability in the event of an injury. Please sign and date:

I understand this program is solely information on trauma informed principles and is not intended as an intervention for those who have experienced trauma. I understand that talking about trauma, even in the context of a workshop, can be triggering. Please sign and date