Name *

First Name

Last Name

Phone *

(###)

###

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What services are you interested in?

Individual

Household

Private In-Home Session

Waiver of Liability *

I understand that this workshop involves physical activity, including lifting and mobility practice. I release Project Health Physical Therapy and Wellness, its staff, and facility from any liability for injury or discomfort resulting from participation.

Yes

No Refund Policy *

All registrations are final. Due to limited spots and preparation costs, no refunds will be issued once registration is submitted. However, you may transfer your spot to another person by emailing us at least 48 hours in advance.

I understand

Media Release *

Photos or short videos may be taken during the workshop for marketing or promotional purposes. By attending, you grant permission for Project Health to use your image unless you request otherwise in the event.

I understand