FOUR-DAY WORKSHOP REGISTRATION PAGE

THIS WORKSHOP IS BEING SCHEDULED AT CLEMENTS HALL IN LATE OCTOBER 2024

IF YOU WOULD LIKE TO BE NOTIFIED WHEN DATES & TIMES ARE SCHEDULED,
PLEASE FILL OUT THE REGISTRATION FORM BELOW

THANKS!

POISED FOR PARKINSON’S:
MANAGING PARKINS0N’S SYMPTOMS OF BALANCE, WALKING, AND FREEZING

For People Living with Parkinson's & their Family Care Partners to enjoy learning together!

An introduction to helpful Alexander technique (AT) principles
to improve your personal management of
balance, walking, and freezing
as well as helping improve your overall quality of life.

Family members and friends, you will get your own wonderful benefits too!

These principles can be easily applied during all your normal daily activities and also during any of your exercise programs or therapy sessions.

This workshop is based on principles from Alexander technique (AT) which is well-known in the performing arts as a way to avoid injury and strain, move with more coordination and grace, and better manage stress and anxiety. The Poise Project has developed and researched this program as a way of bringing this AT training to people living with Parkinson’s and their families.

This workshop is appropriate for participants who are able to walk independently on their own - either without aid or by using a walker or cane.

Come join us and you will take new skills home with you that you can apply right away!

Dates: A Four-Day Workshop

LATE OCTOBER 2024 - Dates to be determined

Time: Time to be determined

Location: Clements Hall, Nunthorpe Rd, York Y023 1BW

Cost: Free

Registration is necessary as space is limited. Please fill in the form below, and you will be contacted to confirm your reservation. We suggest that participants come all four days for optimal enjoyment.

We want everyone to come and enjoy this fun workshop! If you are coming with a family member or friend, please have each person fill out a form separately so that we know how many people are coming. Care partners and people living with a Parkinson's should both register separately. We want everyone to come and enjoy this fun workshop!

CONTACT IF NEEDED for questions: Erica Donnison PHONE: 07771 602665 EMAIL: erica.donnison@thepoiseproject.org

Please fill out and Submit this Registration Form & Waiver. You will be contacted when the dates & times for our October 2024 workshop are scheduled. We look forward to seeing you then!

Name

First Name

Last Name

Email Address

Phone

Country

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What brings you to our workshop?

Please check one

I am a person living with Parkinson's

I am a care partner or friend of a person living with Parkinson's

Would you like to receive our newsletter?

RELEASE AND WAIVER I do hereby release, waive and discharge The Poise Project ("The Poise Project") and their affiliates, trustees, directors, officers, employees, volunteers, assistants and agents (“Releasees”) from any and all liability for injury, loss, damage, obligation, expense or penalty, including attorneys’ fees, that I may cause or sustain in connection with my participation in The Poise Project's one-to-one instruction, group classes, workshops, programs or events whether caused by the negligence or carelessness of Releasees or otherwise. I understand that Releasees do not have medical personnel available at their one-to-one instruction, group classes, workshops, programs or events, and I agree that Releasees assume no responsibility for any injury or damage that might arise out of or in connection with my participation with any of The Poise Project's activities. By signing below, I knowingly and voluntarily assume all such risks, and assume sole responsibility for any accident or injury to myself and other persons or property arising out of or in connection with participation in The Poise Project's one-to-one instruction, group classes, workshops, programs or events. In addition, I have adequate coverage under a health and accident insurance policy applicable to the activities in which I may engage. I further agree that any images or videos taken of me during any of The Poise Project's one-to-one instruction, group classes, workshops, programs or events may be used by The Poise Project for archival documentation or publicity purposes. By agreeing to this Release and Waiver by indicating such in the check box below, I represent that I have read its contents, that I understand it and that I agree to it voluntarily as my own free act and deed. I further state that I am at least eighteen (18) years of age, am fully competent to sign this document and that I execute this Release in consideration of my participation in The Poise Project's activities and programs, fully intending to be bound by same. By submitting this form, I indicate my agreement to this Release and Waiver.

* PLEASE WRITE YOUR NAME BELOW TO INDICATE YOUR SIGNATURE AGREEMENT TO THIS RELEASE AND WAIVER.

York - Poised for Parkinson's Workshop