School Professional Development Booking Form

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School Professional Development Program Booking Form

Please fill out the form below to request a booking for School Professional Development Program, and I will get back to you shortly.

Name of school(Required)

Primary Contact Person Full Name(Required)

Primary Contact Phone(Required)

Primary Contact Email(Required)

Secondary Contact Person Full Name

Secondary Contact Phone

Secondary Contact Email

Who would you like programming for?(Required)

Students

Full classes of students

Small groups of students

Teachers

Student support staff

Teaching support staff

How many participants will be in this session?(Required)

If this is for students, what grades will be participating?

Are all participants able to stand, sit, and do movements on the floor comfortably? If no, please describe how movements are restricted. (Required)

What are the main behavioral concerns you would like to address?(Required)

What are the main learning concerns you would like to address?(Required)

Where would you like to use the exercises and practices from this session?(Required)

Movement Breaks in Class

Outdoor activities

Movement breaks for individual students or small groups

In the gym

Helping to start the day well in class

Keeping the day on track in class

For Teachers in the lounge

What kinds of learning challenges and disabilities do you often see in your participants?(Required)

Would you like to learn skills for participants to:(Required)

Use by oneself

Use with others

Both

Do you have any other issues or concerns you’d like support for?

Lily Massage Therapy is a warm and professional home-based clinic, right in Portugal Cove-St. Philip’s, NL. IT is brought to you by your friendly neighbourhood Registered Massage Therapist, Angela Lily, who is keen to discover and treat the physical and energetic roots of each issue.

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