T H E I N S T I T U T E

F O R R E L A T I O N A L H A R M O N Y S T U D I E S

Certification in Sexological Bodywork - Wave 1

Completion Form - requirement for moving into Wave 2

Please check through every Research Exploration from 01 to 23 and make sure you have completed each RE, posted your reflections and responded to 2 of your classmates.

Name

First Name

Last Name

Phone

Country

(###)

###

####

RE 01 to 23 Completed

What experience or training do you have with embodied practices (such as yoga, massage, meditation, martial arts, Tantra etc)?

What experience or training do you have that could contribute to your work as a Somatic Sex Educator?

Do you have access to therapy or supervision if you require support during this training?

What do you think you may find challenging about the training?

How do you envision making use of what you learn in the training?

Please tell us anything you would like us to know about your ethnicity, gender identity and/or sexual orientation:

If you are living with a disability could you please provide a little detail about the disability and how we might support your learning:

If you are living with trauma could you please provide a little more detail on how it currently affects you:

Any other information you wish to provide?

I have read and agree to the Terms and Conditions.

You can find the Terms and Conditions here: https://www.relationalharmony.institute/agreements-etiquette Please read them before agreeing.

I have read and agree

I have read and agree to work within the CSB code of ethics during the training.

You can find the CSB code of ethics here: https://sexologicalbodyworkers.org/ethics/ Please read them before agreeing.

I have read and agree

I give permission for my contact information to be shared with the teacher support team.

This information will be used by your mentors to support you throughout the training.

I agree

T H E I N S T I T U T E

F O R R E L A T I O N A L H A R M O N Y S T U D I E S

Certification in Sexological Bodywork & Relational Embodiment - Year ONE

Enrolment & Agreement Form

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth

YYYY

Phone

Country

(###)

###

####

Website and/or Facebook ID

http://

Emergency contact details (who would we contact for you in the case of an emergency?)

What interests you about training to qualify as a Sexological Bodyworker, Sexological Intimacy Coach or Somatic Sex Educator?

What experience or training do you have with embodied practices (such as yoga, massage, meditation, martial arts, Tantra etc)?

What experience or training do you have that could contribute to your work as a Somatic Sex Educator?

Do you have access to therapy or supervision if you require support during this training?

What do you think you may find challenging about the training?

How do you envision making use of what you learn in the training?

Please tell us anything you would like us to know about your ethnicity, gender identity and/or sexual orientation:

Please tell us about any physical or mental health issues you may have. This is important for us to know about in order to support you in the learning process:

If you are living with a disability could you please provide a little detail about the disability and how we might support your learning:

If you are living with trauma could you please provide a little more detail on how it currently affects you:

Are there any medications or substances you use?

During this 11 month training are you anticipating any significant changes in your life?

If you have any criminal convictions or been subject to any disciplinary proceedings please declare them here or write "none"

Any other information you wish to provide?

If you join the course, we will share your contact details with your assigned Coach on the CSSE (second year) track. Ensure you have read the entire course description before the Zoom meeting, and note any questions you have. Please note the program requires more than 25 hours a week of study and erotic bodywork during the group online home study Waves. We advise that you don't undertake any other training during this intensive 11 month curriculum.

I have read and agree

I have read and agree to the Terms and Conditions.

You can find the Terms and Conditions here: https://www.relationalharmony.institute/agreements-etiquette Please read them before agreeing.

I have read and agree

I have read and agree to work within the CSB code of ethics during the training.

You can find the CSB code of ethics here: https://sexologicalbodyworkers.org/ethics/ Please read them before agreeing.

I have read and agree

During Online Group Study, I understand approximately 25 hours per week of study time are required

I agree

I understand that I cannot progress to the next Wave without completing all the requirements for the previous Wave and that if I do not complete each consecutive Wave I will not meet the requirements for certification. In this event there will be no refund of the course fee.

I agree

I agree to seek support and to communicate with the teaching team about any issues that I experience that may impede my learning or ability to meet deadlines.

I agree

I give permission for my contact information to be shared with the teacher support team.

This information will be used by your mentors to support you throughout the training.

I agree