Somatic Therapy Toronto

Name

Email

Phone

To increase the safety of the workshop, it may be helpful for everyone to know who is coming to the workshop prior to the first day. We will provide the names of those who are attending the workshop, if we have your consent, on May 25th, 2018.

It is okay to share my name with the group

Yes
No

Where did you hear about this workshop?

Do you identify as a POC?

Yes
No

Would a group restricted to POC benefit you?

Yes
No
N/A

Other comments or questions

Thank you for filling out this form. We will be in touch soon.