lotusgroove&yoga&& · course"description"...

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Lotus Groove Yoga 200Hour Yoga Teacher Training + Student Immersion Where Personal Evolution, Indepth Studies, and Professional Development Converge With Julia Tirabassi + Guests October 2017 – May 2018 Repose Yoga Studio Newburyport, MA “Happiness is not attained through selfgratification but through fidelity to a worthy purpose.” – Helen Keller “They who lack talent expect things to happen without effort. They ascribe failure to a lack of inspiration or ability, or to misfortune, rather than to insufficient application. At the core of every true talent there is an awareness of the difficulties inherent in any achievement, and the confidence that by persistence and patience something worthwhile will be realized. Thus talent is a species of vigor.” – Eric Hoffer Table of Contents: Welcome Letter Course Description Training Overview Training Schedule Meet Your Teacher Registration Information + Eligibility Policies Tuition Options Application

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Page 1: LotusGroove&Yoga&& · Course"Description" “Order&andsimplification&arethefirst&stepstowardthemasteryofasubject& –& theactualenemyistheunknown.” "(TrailGuideto"theBody)" I

Lotus  Groove  Yoga    200-­‐Hour  Yoga  Teacher  Training  +  Student  Immersion    Where  Personal  Evolution,  In-­‐depth  Studies,  and  Professional  Development  Converge  

 With  Julia  Tirabassi  +  Guests  

October  2017  –  May  2018  Repose  Yoga  Studio  Newburyport,  MA  

“Happiness  is  not  attained  through  self-­‐gratification  but  through  fidelity  to  a  worthy  purpose.”  –  Helen  Keller  

“They  who  lack  talent  expect  things  to  happen  without  effort.  They  ascribe  failure  to  a  lack  of  inspiration  or  ability,  or  to  misfortune,  rather  than  to  insufficient  application.  At  the  core  of  

every  true  talent  there  is  an  awareness  of  the  difficulties  inherent  in  any  achievement,  and  the  confidence  that  by  persistence  and  patience  something  worthwhile  will  be  realized.  Thus  talent  

is  a  species  of  vigor.”  –  Eric  Hoffer  Table  of  Contents:  

• Welcome  Letter  J  • Course  Description  • Training  Overview    • Training  Schedule  • Meet  Your  Teacher  • Registration  Information  +  Eligibility  Policies   • Tuition  Options    • Application    

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NAMASTE  *  Greetings  and  Kudos!  *  

I’m  going  to  go  ahead  and  make  an  assumption:  you’re  reading  these  words  because  you’re  curious.        Perhaps,  you’re  interested  in  knowing  how  a  structured  yoga  education  is  organized  and  presented;  perhaps,  the  yoga  profession  intrigues  you  and  you’re  considering  stepping  on  the  path  towards  becoming  a  yoga  teacher;  perhaps,  you’ve  been  an  avid  practitioner  for  years  and  you’ve  decided  that  it’s  time  to  take  your  practice  to  the  next  level  and  learn  about  the  logic  behind  the  poses  you’ve  fallen  in  love  with.    For  all  of  this  –  and  more  –  I  applaud  your  curiosity!      

There’s  a  well-­‐known  saying:  “Every  journey  begins  with  a  single  step,”  which  is  an  adaption  of  a  Lao-­‐tzu  quote:  “A  journey  of  a  thousand  miles  begins  with  a  single  step.”    This  Information  Packet  –  combined  with  YOUR  curiosity  –  represents  your  first  step  on  the  road  towards  transforming  your  relationship  with  yoga.    And  when  I  say  transforming,  I  mean:  TRANSFORMING!    Make  no  mistake:  a  7-­‐month-­‐long  yoga  immersion  WILL  change  your  practice;  it  WILL  alter  your  understanding  and  appreciation  of  yoga;  and  it  WILL  –  inevitably  and  irretrievably  –  shift  the  way  you  perceive  yourself,  your  practice,  your  body,  and  the  world.    

Whichever  species  of  curiosity  has  led  you  to  this  moment  in  time,  I’m  grateful  that  you’re  here.    Thank  you  for  taking  the  time  and  investing  your  attention  to  consider  the  possibility  of  diving  deep  into  a  concentrated  study  of  yoga’s  vast  context.    

As  you  peruse  the  following  materials,  you’ll  see  quickly  that  this  program  is  designed  to  be  rigorous  and  to  expand  the  understanding  of  serious  yoga  students  with  the  sincerest  degree  of  interest  in  growing  their  practice  and  expanding  their  knowledge  base.    Over  the  course  of  7-­‐yoga-­‐packed-­‐months  you’ll  immerse  yourself  in  a  wide  range  of  topics,  including:  yoga’s  historical  background,  fundamental  principles  of  skillful  and  intelligent  practice,  the  basics  of  applied  anatomy  and  understanding  of  how  body  biomechanics  inform  the  poses,  the  importance  of  establishing  a  home  practice,  the  value  of  participating  in  a  conscious  community  of  like-­‐minded  yogis,  and  how  to  craft  congruent  lifestyle  practices.    I’m  so  excited  to  share  all  of  these  details  with  you!    

When  and  if  you  decide  you’re  indeed  ready  to  take  the  plunge  and  jump  into  the  first  leg  of  your  Yoga  Ed.  Odyssey,  I  hope  you’ll  consider  me  an  eager  and  honored  guide.  I  commend  your  studentship  and  would  be  thrilled  to  support  you  in  your  yoga  scholarship.        NAMASTE,  

   

Julia  

   

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Course  Description  

“Order  and  simplification  are  the  first  steps  toward  the  mastery  of  a  subject  –  the  actual  enemy  is  the  unknown.”  (Trail  Guide  to  the  Body)  

 I’m  guessing  you’re  already  in  love  with  Yoga.    Right  on!    Yoga  practice  is  uniquely  addictive,  isn’t  it?!    Unlike  other  forms  of  movement  or  fitness,  yoga  directly  addresses  the  needs  of  both  the  mind  and  the  body  simultaneously,  lending  this  discipline  an  integrated  appeal  that  reaches  beyond  the  physical.    If  you  have  indeed  already  fallen  in  love  with  this  practice  and  find  yourself  in  a  place  of  readiness  to  study  more  deeply,  to  develop  and  progress  your  practice,  to  join  a  conscious  community  of  kindred-­‐spirits,  and  to  prepare  yourself  for  the  possibility  of  entering  into  the  Yoga  profession,  then  the  time  has  come  for  your  yoga  education  to  begin!  

In  this  one-­‐of-­‐a-­‐kind  program  you’ll  receive  an  exceptional  education  in  yoga  fundamentals.    Over  the  course  of  7-­‐months,  you’ll  steep  yourself  in  the  hidden  topics  behind  the  poses  –  the  breadth  of  yoga’s  context  will  be  revealed,  clarified,  experienced,  studied,  explained  and  explored  in  a  highly-­‐interactive  and  supportive  setting.    The  training  will  take  place  in  Newburyport,  MA  at  the  gorgeous  Repose  Yoga  Studio.    Julia  Tirabassi  will  be  your  primary  guide  and  honored  leader.    Throughout  the  duration  of  the  course,  you’ll  also  enjoy  learning  from  several  adjunct  faculty  who  are  each  uniquely  qualified  to  enhance  your  understanding  of  special  subjects,  such  as:  Sanskrit,  Ayurveda,  restorative  practice  and  injury  considerations  +  prevention.  

This  comprehensive  curriculum  is  designed  to  challenge,  inspire,  educate  and  develop  the  committed  student.    Students  with  a  serious  dedication  and  sincere  hunger  to  study  and  learn  will  most  benefit  from  this  immersive  experience.  You  can  expect  a  premium  quality  program  on  all-­‐levels,  including:    

Ø Top-­‐notch  study  materials,    Ø The  compassionate  guidance  of  highly-­‐experienced,  passionate  and  professional  

trainers,    Ø Profound  development  and  progression  of  your  personal  practice,  Ø Tutelage  towards  establishing  a  sustainable  home  practice,  Ø Prodigious  and  enriching  instruction  intended  to  demystify  the  details  of  practice,  Ø Avid  accountability,  and    Ø Rigorously  high  standards  from  day  one!  

 

This  entry-­‐level  course  promises  to  deliver  a  complete  package  of  “everything-­‐you-­‐always-­‐wanted-­‐to-­‐know-­‐about-­‐yoga-­‐but-­‐didn’t-­‐know-­‐to-­‐ask”.    Throughout  the  course,  you’ll  certainly  go  deep  into  what  the  mat  has  to  offer,  but  you’ll  also  learn  the  logic  and  context  behind  the  physical  practice.  There’s  a  vast  universe  of  teachings,  practices,  wisdom  and  insights  hiding  behind  the  somatic  experience  we  enjoy  on  the  mat.  You  can  expect  to  emerge  after  7-­‐months  a  more  knowledgeable,  skillful,  and  adept  student.    

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Who’s  This  Training  For?  

This  course  has  been  scrupulously  designed  for  serious  students.    The  content  contains  a  thorough  introduction  to  the  world  of  yoga,  as  well  as  providing  the  basic  tools  to  get  new  teachers  started  on  their  teaching  path.    It  is  NOT  required  that  you  aspire  to  teach.    This  curriculum  will  serve  sincere  students  as  a  comprehensive  immersion  into  the  logic,  context  and  background  of  practice.    Students  of  every  persuasion  will  benefit  from  this  sort  of  education.    Again  –  it  is  not  expected  –  nor  assumed  –  that  you’ll  go  on  to  teach  yoga.    However,  should  you  choose  to  pursue  yoga  as  a  profession,  this  course  will  set  you  up  with  everything  you  need  to  begin  a  teaching  career.  

As  a  participant  in  this  program,  you  can  expect  to  delve  deep  into  a  wide  range  of  topics  -­‐  all  while  furthering  your  personal  practice  -­‐  under  the  careful  tutelage  of  Julia  Tirabassi.  Julia  is  a  seasoned  professional  with  nearly  18  years  of  experience  teaching  movement  and  15  dedicated  years  of  experience  as  a  full-­‐time  yoga  teacher.    In  her  role  as  a  teacher  trainer,  it  is  Julia's  most  earnest  aim  to  provide  a  skillful  and  structured  support  system  for  yogis  at  the  beginning  stages  of  both  their  yoga  education  and  their  professional  development.        A  training  and  immersion  of  this  magnitude  requires  a  true  commitment.    Your  sincerest  dedication  to  the  learning  process,  an  eagerness  to  learn,  a  passionate  curiosity  about  the  content,  a  willingness  to  delve  into  uncharted  territory,  and  an  avid  devotion  to  your  personal  practice  are  all  necessary  requirements  for  trainees.      

In  addition,  Julia  requires:  

• You  have  at  have  at  least  3  years  of  previous  yoga  experience  • You  are  able  to  attend  all  scheduled  training  sessions  • You  have  a  regular  practice  already  in  place  • You  are  willing  to  commit  to  a  regular  HOME  practice  for  the  duration  of  the  program  • You  are  capable  of  completing  frequent  and  challenging  homework  assignments  • You  are  committed  to  the  overall  demands  of  the  curriculum    • You  are  excited  to  study,  learn  and  practice  in  the  company  of  kindred  spirits!  

   

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The  Curriculum      This  comprehensive  survey  course  spans  the  gamut  of  essential  yoga  subjects  and  basic  classroom  skills  for  both  curious  students  and  aspiring  teachers  alike.    Whether  you  intend  to  pursue  yoga  professionally  or  not,  you’ll  benefit  immensely  from  this  immersive  study.    Here  are  some  of  the  highlights  you  can  expect  from  this  foundational  education  in  all-­‐things-­‐yoga:  

• Bringing  Om  Home:  Fostering  a  Sustainable  Home  Practice  • The  History  of  Yoga,  the  context  of  practice,  and  the  evolution  of  modern  practice  • A  careful  consideration  of  The  Origins  of  Asana  • Ancient  traditions,  including:  Vedanta,  the  Bhagavad  Gita,  Patanjali’s  Yoga  Sutras  +  Raja  

Yoga,  Hatha  Yoga  +  Tantra,  subtle  anatomy  +  classical  practices    • Chanting,  mantra,  and  Introduction  to  the  Sanskrit  language  • Sanskrit  Essentials  for  Yoga  Teachers  • Lengthy  and  detailed  alignment-­‐based  asana  practices  • Foundational  Principles  of  Practice  • The  TADA  Template:  Tadasana  in  Every  Asana  • Fundamental  Anatomy    • Essential  principles  of  movement  science  as  it  applies  to  asana  • Applied  anatomy  +  principles  of  structural  intelligence  • Detailed  alignment  principles  of  30  Essential  Poses    • Asana  Analysis  Methodology    • Understanding  Standing  Poses:  Closed  vs.  Open  Hips  • Creating  Pelvic  Harmony:  learning  to  stabilize  the  hip  joints  for  long-­‐term  health  and  

function  • Adho  Mukha  Svanasana  Tutorial  • Sirsasana  Tutorial  • Chaturanga  Dandasana  Tutorial  • Bakasana  +  Lolasana  Tutorial  • Pincha  Mayurasana  Tutorial  • Urdhva  Dhanurasana  Tutorial  • Classical  Surya  Namaskar  +  Surya  Namaskar  A  +  B  Tutorials  • Surya  Namaskar  Practicums  • Mechanics  of  Breath  +  Basic  Pranayama  Techniques  • Core  Essentials  +  Bandha  Investigations  • Development  of  observation  skills  +  the  basics  of  body  reading  • Verbal  skills  and  guidance  on  how  to  verbally  lead  a  yoga  class  • The  art  +  science  of  skillful  and  savvy  sequencing  • Sequencing  principles,  methods,  and  structures  for  flawless  classes  • Practice  teaching  (practicums)  in  a  constructive,  creative,  and  supportive  setting  

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LGY  YTT  Schedule:  October  2017  –  May  2018    The  program  is  structured  as  a  local  training  for  working  folks.    Sessions  are  scheduled  according  to  a  15-­‐hour  Saturday  +  Sunday  WEEKEND  format.    In  total  there  are  13,  15-­‐hour,  weekends.  Sessions  all  run:  11:30AM  –  7:30PM  Daily  [a  30-­‐minute  break  will  be  included  each  day].  All  sessions  will  be  held  at  Repose  Yoga  Studio  in  Newburyport,  MA.  

OCTOBER  2017    

October  7th  +  8th    October  21st  +  22nd      NOVEMBER  2017    

November  4th  +  5th    November  18th  +  19th      DECEMBER  2017    

December  2nd  +  3rd      JANUARY  2018    

January  13th  +  14th    January  27th  +  28th        FEBRUARY  2018    

February  10th  +  11th      February  24th  +  25th        MARCH  2018    

March  10th  +  11th    March  24th  +  25th        APRIL  2018    

April  14th  +  15th    April  28th  +  29th      MAY  2018    SUNDAY,  May  5th:  GRADUATION  DAY!  [Hours  TBD]    

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Meet  Your  Teacher  

Your  primary  teacher  for  this  curriculum  will  be  Julia  Tirabassi.    Julia  has  lovingly  and  meticulously  prepared  this  200-­‐hour  course  for  you!    It  is  her  original  creation,  born  of  (literally!)  thousands  of  hours  of  yoga  experience  as  a  classroom  teacher,  mentor  and  teacher  trainer.    

Longtime  Portsmouth,  NH  resident,  Julia  has  been  teaching  Yoga  professionally  for  15  years  in  the  seacoast  region  of  NH,  as  well  as  multiple  locations  in  Maine  and  Massachusetts.  As  a  former  personal  trainer,  it  was  her  passion  for  movement  and  an  on-­‐going  fascination  with  the  body’s  unlimited  potential  that  led  her  to  a  full-­‐time  career  as  an  

independent  Yoga  teacher.  She  formed  her  own  solo-­‐preneur  business,  Lotus  Groove  Yoga,  in  2006.      In  her  work  as  a  traveling  teacher,  Julia  has  offered  classes,  workshops,  mentorship  programs  and  teacher  trainings  in  NH,  ME,  and  MA.  She  is  best  known  for  her  clarity,  proficiency,  and  authenticity.    An  avid  movement  enthusiast,  asana  addict,  alignment  geek,  and  strength  fanatic,  Julia  infuses  all  of  her  teaching  with  an  impassioned  knowledge  of  sound  bio-­‐mechanics,  applied  anatomy,  functional  efficiency,  and  an  overall  zest  for  exuberant  embodiment.    

 Eternally  true  to  her  days  as  a  fitness  trainer,  Julia’s  teaching  style  continues  to  include  plenty  of  athleticism,  but  has  evolved  into  a  unique  “special  blend”  of  creative  physicality,  sweaty  satisfaction,  mindful  movement,  and  keen  attention  to  deep  detail.  In  each  and  every  moment,  Julia  strives  to  guide  her  students  in  continuously  fresh  and  skillful  ways  towards  manifesting  their  personal  expression  of  empowered  grace.      In  her  role  as  a  teacher  trainer,  it  is  her  sincerest  honor  and  privilege  to  gracefully  guide  aspiring  teachers  on  their  path  and  to  serve  the  global  spread  of  yoga's  magnificence  with  ecstatic  integrity.    

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Registration  Information  +  Eligibility  Policies  

All  applicants  must  complete  a  written  application.    The  application  is  included  here.  Please  print  out,  complete,  and  return  your  application  via  mail  or  in-­‐person  to  Gin  Evans  at  Repose  Yoga  in  Newburyport,  MA  (address  to  follow).  

Please  submit  your  application  prior  to  the  Application  Deadline  of:  Saturday,  September  16th,  2017  

 

Applications  will  be  reviewed  and  approved  in  order  of  submission.    This  training  is  limited  to  no  more  than  16  participants  and  applicants  will  be  admitted  on  a  first-­‐come,  first-­‐serve  basis.    To  ensure  your  admission,  please  apply  as  soon  as  possible,  but  no  later  than  the  deadline  of  Saturday,  September  16th,  2017.    Once  your  application  has  been  approved,  and  you’ve  been  accepted  into  the  training,  you’ll  receive  a  Commitment  Contract.    All  participants  will  be  required  to  sign  this  contract,  which  outlines  the  program’s  payment  and  participation  policies.  

There  is  a  non-­‐refundable  $500  deposit  due  upon  your  acceptance  into  the  program.  

Applicants  are  STRONGLY  encouraged  to  meet  Julia  –  and  familiarize  themselves  with  her  style  and  personality  –  prior  to  the  start  of  training.    If  you’re  not  already  a  student  of  Julia’s,  please  plan  to  attend  a  minimum  of  3  classes/workshops/events  with  her  as  soon  as  possible.  Meeting  and  getting  to  know  your  teacher  is  an  essential  ingredient  to  making  an  informed  decision  regarding  your  participation  in  this  program.  

ELIGIBILITY  POLICY:    

Applicants  must  be  at  least  18  years  of  age  and  have  been  practicing  yoga  for  at  least  three  years.    

REQUIREMENTS:    

A  training  and  immersion  of  this  magnitude  requires  a  true  commitment.    Your  sincerest  dedication  to  the  learning  process,  an  eagerness  to  learn,  a  passionate  curiosity  about  the  content,  a  willingness  to  delve  into  uncharted  territory,  and  an  avid  devotion  to  your  personal  practice  are  all  necessary  requirements.  

In  addition,  Julia  requires:  

• You  have  at  have  at  least  3  years  of  previous  yoga  experience  • You  have  a  regular  yoga  practice  already  in  place  • You  are  willing  to  commit  to  a  regular  HOME  practice  for  the  duration  of  the  program  • You  are  capable  of  completing  frequent  and  rigorous  homework  assignments  • You  are  committed  to  the  overall  demands  of  the  curriculum    • You  are  excited  to  study,  learn  and  practice  in  the  company  of  kindred  spirits!  

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Tuition  Options    The  Lotus  Groove  Yoga  200-­‐Hour  Yoga  Teacher  Training  +  Student  Immersion  offers  two  payment  options  (all  inclusive  of  the  required  books  and  the  training  manual).      Upon  acceptance,  applicants  will  submit  a  signed  commitment  contract  and  a  $500  non-­‐refundable  deposit  to  secure  space  in  the  training.  By  signing  the  commitment  contract  applicants  are  agreeing  to  pay  the  tuition  in  full.  Those  on  the  payment  plan  will  be  charged  as  per  the  payment  schedule.      

PAYMENT  OPTIONS:  

• $3,000  if  paid  in  full    • $3,200  with  payment  plan  ***  • $500  non-­‐refundable  deposit  due  with  signed  contract    

 ***All  payment  plan  payments  must  be  by  credit  card.    

 CANCELLATION  POLICY:  

Cancellations  made  prior  to  September  16th  (more  than  3  weeks)  before  the  start  of  the  training  on  October  7,  2017  will  receive  a  tuition  refund  less  the  $500  deposit.  There  are  no  tuition  refunds  less  than  3  weeks  before  the  start  or  during  the  training,  but  a  credit  towards  a  future  Teacher  Training  may  be  available.  If  you  do  not  complete  the  training  we  do  not  offer  refunds.    

ATTENDANCE  POLICY:      Graduation  from  this  program  is  not  guaranteed.  Your  commitment,  attendance,  and  participation  are  required.  In  order  to  be  granted  your  certificate  of  completion,  you  must  invest  yourself  earnestly  and  complete  at  least  90%  of  the  training  hours,  pass  your  final  exam,  complete  your  final  project,  and  fulfill  all  other  training  requirements.  Should  you  miss  more  than  10%  of  the  contact  hours,  you  forfeit  your  eligibility  to  graduate.  

Julia  must  approve  any  absences  prior  to  the  beginning  of  training.    

Arrangements  for  make-­‐up  hours  can  be  made  for  illness  and  emergency.    

   

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Lotus  Groove  Yoga  200-­‐Hour  Yoga  Teacher  Training  +  Student  Immersion  

APPLICATION    

 Thank  you  for  your  interest  in  the  Lotus  Groove  Yoga  200-­‐Hour  Yoga  Teacher  Training  +  Student  Immersion  Course.  Please  print  out,  complete,  and  return  your  application  via  mail  or  in-­‐person  to  Gin  Evans  at  Repose  Yoga  in  Newburyport,  MA.    Repose  Yoga  Studio  49  Liberty  Street  Newburyport,  MA  01950  (508)  423-­‐3182    Please  submit  your  application  prior  to  the  Application  Deadline  of:  Saturday,  September  16th,  2017    If  you  have  any  questions  or  concerns  regarding  this  application,  please  contact  Gin  Evans  at:    [email protected]    (508)  423-­‐3182      Name:  ____________________________________________________________________________________              

Phone  #:  __________________________________________________________________________________  

Address:___________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________      

Email:_____________________________________________________________________________________    

Date  of  Birth:  ______________________________________________________________________________  

Emergency  Contact  Name  &  Phone:  ____________________________________________________________  

Occupation:  ________________________________________________________________________________    Do  you  have  an  interest  in  becoming  a  yoga  teacher?    Or,  would  you  be  participating  in  this  program  as  a  student  looking  simply  to  immerse  yourself  in  deeper  yoga  studies?    __________________________________________________________________________________________

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Please  respond  to  the  following  accurately  and  honestly.  All  information  shared  herein  will  be  held  in  the  strictest  of  confidence.        How  long  have  you  been  practicing  yoga?    And,  how  did  you  get  started  in  yoga?    __________________________________________________________________________________________

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 What  style(s)  and/or  methods  of  practice  would  you  say  best  define(s)  your  practice?    __________________________________________________________________________________________    __________________________________________________________________________________________    __________________________________________________________________________________________    __________________________________________________________________________________________      

On  a  separate  piece  of  paper,  please  provide  a  brief  history  (1-­‐2  pages)  of  your  practice.    What’s  your  yoga  story?        On  a  separate  piece  of  paper,  please  describe  some  of  your  strengths  and  weaknesses  as  a  yoga  practitioner.    On  a  separate  piece  of  paper,  please  list  your  most  influential  yoga  teachers  to  date.    How  often  and  how  long  have  you  studied  with  them?    What  about  their  teachings  have  held  the  greatest  significance  for  you?    On  a  separate  piece  of  paper,  please  discuss  your  interest  in  this  program.    Why  are  you  applying  to  this  200-­‐hr.  course?    Additionally,  please  include  some  thoughts  on  what  you  hope  to  gain  from  this  experience,  should  you  be  accepted  into  the  program.      Please  provide  a  Letter  of  Reference  (1  page)  from  a  current/former  yoga  teacher  of  yours  with  whom  you  have  an  established  relationship.    Please  request  that  your  teacher  provide  responses  to  the  following:    

1. Name  of  Applicant  2. Briefly  describe  how  long  and  in  what  capacity  you  have  known  the  applicant.  3. Briefly  describe  why  you  would  recommend  this  applicant  for  the  Lotus  Groove  200-­‐Hour  Student  

Immersion  +  Professional  Preparation  Course.  What  unique  assets  does  this  individual  possess  that  would  support  them  in  a  7-­‐month-­‐long  training  program?  

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HEALTH  INFORMATION    Are  you  currently  under  medical  supervision  for  any  condition  (including  pregnancy)?  If  so  please  state  type  of  condition  and  list  Dr.  contact  information:      __________________________________________________________________________________________  

 

__________________________________________________________________________________________  

 Do  you  have  any  physical  limitations,  past  surgeries,  or  injuries?    If  so,  please  offer  a  brief  description  of  each,  as  well  as  the  treatments  (if  any)  you’ve  undergone:    __________________________________________________________________________________________    __________________________________________________________________________________________    __________________________________________________________________________________________    __________________________________________________________________________________________    __________________________________________________________________________________________    __________________________________________________________________________________________    __________________________________________________________________________________________    __________________________________________________________________________________________      Please  feel  welcome  to  share  any  additional  thoughts,  ideas,  information  or  concerns:    __________________________________________________________________________________________

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