Course Participant Consent Form

Thank you for participating in this exciting course.  In order to maximize your benefit from this continuing education session, you will be asked to participate as a subject (model) as well as a provider of manual therapy and neuromuscular re-education in your setting.  Demonstrations and treatment practice are an integral part of the course, and will require you to be positioned in specific movement pattern positions, in lab attire.  The purpose of this participation is to establish basic practical application of the techniques of the course. It is your responsibility to inform those who you are working with of any pertinent medical information or issues you have related to the techniques that may be of significance.

I, (clicking terms agreement) releases Integrated Movement Health, Christopher DaPrato DPT, UCSF, and all course officers and agents from any and all liability, claims, or actions of any kind that may arise from or in connection with my participation hereunder.  Should an undesired reaction or side effects occur at any point during or after the course as a result for treatment delivered or received, I understand it is my responsibility to seek medical attention from my own provider, and do not hold responsibility or liability to those listed above.  No monetary gain, free treatment, or other compensation shall be rendered as a result of injury, regardless of negligent actions taken from the course providers or participants.  If any portions of this release of liability form are found to be invalid by a court, the remainder of all other disclosures described is to remain fully in effect. 

I agree to inform the other participants or instructors of any medical issues I may have that would be a precaution or contraindication to performing or receiving treatment during the course, and will remove myself from any particular treatment technique which I do not feel comfortable with, without penalty or prejudice.  I again, understand that it is my responsibility to monitor my body’s response to the treatments, and take the necessary steps to any side effects accordingly through an outside medical provider.

By clicking below, I consent to full participation in the course MFD Level 1, at the location of your choice, and agree with any and all disclosures deemed necessary from Integrated Movement Health.