Information & Intake Questionnaire
Authorization to Release Records
Responsibility for Payment
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Kinesio Taping Seminars (Click for more information.)
APPROVED BY KTA (Kinesio Taping Association)
APPROVED FOR CEU’S (PTs, PTAs, OTs, COTAs, MTs, & ATCs)
KT1 & KT2
Sunday-Monday, March 4-5, 2012
8:30am–6:00pm
TOURO COLLEGE
West 23rd Street, Manhattan
CHECKS ONLY: $599
CLICK HERE TO REGISTER for the KT1 & KT2
Send your check ASAP to reserve your place in the class.
If you also wish to take the KT3 on May 6, do not wait to sign up.
(Just email us and we can use your information from the KT1 & KT2.)
KT3
Sunday, May 6, 2012
8:00am–5:30pm
MEMORIAL SLOAN-KETTERING CANCER CENTER
430 East 67th Street, Manhattan
CHECKS ONLY: $299 • $250 for MSKCC participants
CLICK HERE TO REGISTER for the KT3
Send your check ASAP to reserve your place in the class.
ATTENTION MSKCC ATTENDEES:
You will be guaranteed a place in the KT3 class for $250 until March 1, 2012.
After March 1, we will accept all registrations on a first-come, first-served basis.
If you also wish to take the KT3 on May 6, do not wait to sign up.
(Just email us and we can use your information from the KT1 & KT2.)
APPROVED BY KTA (Kinesio Taping Association)
APPROVED* FOR CEU’S (PTs, PTAs, OTs, COTAs, MTs, & ATCs)
*pending for IPTA
KT1 & KT2, KT3 PACKAGE
Thursday, April 19 & Saturday, April 21, 2012, Friday, May 18, 2012
8:00am–5:30pm
COUNTRY INN AND SUITES
1837 Centre Point Circle, Naperville, IL 60563
CHECKS ONLY: $775* (Save $123) • $675 (Manor Care by 3/15 – Save $223)
* There is no early-bird for the package. Please mark $775 or $675 on the form.
CLICK HERE TO REGISTER FOR THE KT1 & KT2, KT3 PACKAGE
Send your check ASAP to reserve your place in the class.
KT1 & KT2
Thursday, April 19 & Saturday, April 21, 2012
8:00am–5:30pm
COUNTRY INN AND SUITES
1837 Centre Point Circle, Naperville, IL 60563
CHECKS ONLY: $599* • $550 (Manor Care by 3/15)
* There is no early-bird for the course; Please mark $599 or $550 on the form.
CLICK HERE TO REGISTER for the KT1 & KT2
Send your check ASAP to reserve your place in the class.
KT3
Friday, May 18, 2012
8:00am–5:30pm
COUNTRY INN AND SUITES
1837 Centre Point Circle, Naperville, IL 60563
CHECKS ONLY: $299 • $275 (early-bird) • $250 (Manor Care by 3/15)
CLICK HERE TO REGISTER for the KT3
Send your check ASAP to reserve your place in the class.
ATTENTION MANOR CARE ATTENDEES:
You will be guaranteed a place in the KT1 & KT2 and KT3 until March 15, 2012.
After March 15, we will accept all registrations on a first-come, first-served basis.
Arthritis · Back Pain · Bursitis · Dance Injuries · Carpal Tunnel Syndrome · Headaches · Herniated Discs · Radiculopathy · Spinal Stenosis · Myofascial Pain Syndrome
Neck Pain · Plantar Fasciitis · Sciatica Shin Splints · Spondylolysis & Spondylolisthesis · Sports Injuries · Sprains · Tendonitis · TMJ · Whiplash