REGISTRATION FORM

"PARTNERING WITH POISE"

ALEXANDER TECHNIQUE (AT) BASED SELF-CARE COURSE
FOR CARE PARTNERS OF PEOPLE LIVING WITH
ALZHEIMER’S DISEASE OR RELATED DEMENTIAS

 

Times: Thursdays from 1:00pm-2:30pm

Dates:  August 22 - October 24, 2019

Location:  Mount Holly Historical Society, 131 South Main Street, Mount Holly NC 28120

Cost:         Free for care partners


Registration is necessary. Please fill out the form below to secure your place.

This course if for care partners independent of their care receiver.

The program consists of a group class meeting for 90 minutes once a week for 10 weeks.
(NOTE: The first and last class are for two hours each.)

It is understood that some participants may not be able to attend every class.

If you would like to see video interviews with two care partner participants who have taken this course, you may go to: Betty - https://youtu.be/gvvikiDygFk Tom - https://youtu.be/awcN5b_eg3I

 QUESTIONS?  Karen Kleiner, Course Instructor Karen@anatomywise.com or 980-477-0508

Please fill out and Submit the Registration Form & Waiver. Someone will contact you then to confirm your participation.
Name *
Name
Phone *
Phone
Address *
Address
I am caring for *
* PLEASE WRITE YOUR NAME BELOW TO INDICATE YOUR SIGNATURE AGREEMENT TO THIS RELEASE AND WAIVER.