Scarwork Course Booking Form

Name*

First Last

Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Email*

Therapy Qualifications*

Years of experience as a therapist (minimum 1 year and currently in practice required)

Work Experience*

Therapy Qualifications

How did you hear about the course?*

Medical Conditions*

Medical conditions we need to know about and scars you have on your body

COURSE AGREEMENT: I agree that Body in Harmony Training (BIHT) may hold my personal details and add my name to an email list in order to receive information/news on the subject of scars, other courses run by Sharon Wheeler, plus information on courses run by any of the accredited ScarWork tutors in the UK. I understand that my name and email will be available to all UK ScarWork tutors to provide me with information on post-grad courses and that I can unsubscribe at any time.*

COURSE AGREEMENT: I agree that Body in Harmony Training (BIHT) may hold my personal details and add my name to an email list in order to receive information/news on the subject of scars, other courses run by Sharon Wheeler, plus information on courses run by any of the accredited ScarWork tutors in the UK. I understand that my name and email will be available to all UK ScarWork tutors to provide me with information on post-grad courses and that I can unsubscribe at any time.

Yes
No

I consent to Body in Harmony Training adding my name to the email list to receive the monthly blog and course updates. I am free to unsubscribe at any time.*

I consent to Body in Harmony Training adding my name to the email list to receive the monthly blog and course updates. I am free to unsubscribe at any time.

Yes
No

I consent to the use of photos/videos (face not shown) taken on this course on social media or the BIHT website to promote ScarWork*

I consent to the use of photos/videos (face not shown) taken on this course on social media or the BIHT website to promote ScarWork

Yes
No

PLEASE TICK THE BOX TO CONFIRM THE FOLLOWING: I agree that no photos/videos made of my fellow students’ scars and range of movement etc. on my devices will be used in any public domain, eg website, social media, advertising, without the full, signed consent of that student. I will not share the photos/videos with anyone other than students on the course.*

PLEASE TICK THE BOX TO CONFIRM THE FOLLOWING: I agree that no photos/videos made of my fellow students’ scars and range of movement etc. on my devices will be used in any public domain, eg website, social media, advertising, without the full, signed consent of that student. I will not share the photos/videos with anyone other than students on the course.

Yes

UntitledI agree that I will not take photos/videos of the members of the public (scar models) with my own device, only with their own if they wish. All other photos/videos will be taken by the tutor or teaching assistants.*

I agree that I will not take photos/videos of the members of the public (scar models) with my own device, only with their own if they wish. All other photos/videos will be taken by the tutor or teaching assistants.

Yes

I will not replicate or distribute the materials from this course in any format whatsoever, nor will I share the private YouTube link to the first 9 techniques provided by Sharon Wheeler, and will respect that it is the copyrighted property of Sharon Wheeler, and elements are the intellectual property of Jan Trewartha of BIHT.*

I will not replicate or distribute the materials from this course in any format whatsoever, nor will I share the private YouTube link to the first 9 techniques provided by Sharon Wheeler, and will respect that it is the copyrighted property of Sharon Wheeler, and elements are the intellectual property of Jan Trewartha of BIHT.

Yes

Please note – if required by government or common-sense guidelines, we will instigate precautions as needed to deal with any current virus situations. These may include masks, extra sanitising, and changes in how we run the class to reduce the number of people you are in personal contact with. If you have concerns about any of these precautions, please contact the tutor immediately so that we can discuss how best to accommodate you. Thank you for your cooperation.*

Please note – if required by government or common-sense guidelines, we will instigate precautions as needed to deal with any current virus situations. These may include masks, extra sanitising, and changes in how we run the class to reduce the number of people you are in personal contact with. If you have concerns about any of these precautions, please contact the tutor immediately so that we can discuss how best to accommodate you. Thank you for your cooperation.

I agree

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