TCA/FP Registration Form for Monthly Instructor Series

Tai Chi for Arthritis and Fall Prevention Monthly Series Registration for Certified Instructors

Tai Chi for Arthritis and Fall Prevention Monthly Series Registration for Certified Instructors

Tai Chi for Arthritis and Fall Prevention Certification Status - Please check all that apply: *
Acknowledgement of Personal Responsibility & Waiver: I understand that there is an inherent risk in any exercise activities. I agree to abide by the rules set out by my instructor. In consideration for admission to this workshop series, I hereby: (a) accept full responsibility for and assume the risk of any injuries sustained because of my participation in this series for practice of tai chi; (b) release and hold harmless the High Country Area Agency on Aging, its respective employees and directors, the instructor(s) and all personnel in association with the series for any liabilities, injuries and expenses which may arise as a result of participation in this series, practice or lessons involving tai chi. I know of no medical reasons why I should not participate in this workshop series. I understand that if I do have any medical reasons to not participate in this class, it is my responsibility to obtain a clearance from my doctor prior to starting.
By typing your name in this blank you agree to the waiver.
Optional: Please list below any particular interests or skills related to teaching TCA/FP that you hope to learn and develop as part of participating in this skills builder series. Thank you.