Learn to Teach Price: $660 First Name:* First Name Required Last Name:* Last Name Required Address Line 1:* Address Line 1 is Required Address Line 2: Address Line 2 is not valid City:* City is Required Country:* Country is Required -- Select Country -- Australia Afghanistan Åland Islands Albania Algeria Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belau Belize Benin Bermuda Bhutan Bolivia Bonaire, Saint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo (Brazzaville) Congo (Kinshasa) Cook Islands Costa Rica Croatia Cuba CuraÇao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Republic of Ireland Isle of Man Israel Italy Ivory Coast Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao S.A.R., China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Norway Oman Pakistan Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Martin (Dutch part) Saint Pierre and Miquelon Saint Vincent and the Grenadines San Marino São Tomé and Príncipe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia/Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom (UK) United States (US) Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Wallis and Futuna Western Sahara Western Samoa Yemen Zambia Zimbabwe State/Province:* State/Province is Required Zip/Postal Code:* Zip/Postal Code is Required Event: Event is not valid Venue: Venue is not valid Date: Date is not valid Mobile Phone Number:* Mobile Phone Number is Required Gender:* Gender is Required Male Female Prefer not to say Age in years:* Age in years is Required Company Name (Enter NA for Individual):* Company Name (Enter NA for Individual) is Required Where did you hear about us?:* Where did you hear about us? is Required FriendFacebookNewsletterGoogleNews ArticleClass Instructor PRE-EXERCISE HEALTH SCREENING - please see notes at bottom of page*Time Out Tai Chi is designed to be a light to light-moderate form of exercise. If you have been inactive, we recommend pacing yourself and slowly increasing your volume and intensity.I have been cleared to participate in this Time Out Tai Chi course as my doctor has cleared me to exercise or I am able to answer NO to the following:* PRE-EXERCISE HEALTH SCREENING - please see notes at bottom of page*Time Out Tai Chi is designed to be a light to light-moderate form of exercise. If you have been inactive, we recommend pacing yourself and slowly increasing your volume and intensity.I have been cleared to participate in this Time Out Tai Chi course as my doctor has cleared me to exercise or I am able to answer NO to the following is Required Has your medical practitioner ever told you that you have a heart condition, or have you ever suffered a stroke? Do you ever experience unexplained pains or discomfort in your chest at rest or during physical activity/exercise? Do you ever feel faint, dizzy or lose balance during physical activity/exercise? Have you had an asthma attack requiring immediate medical attention at anytime over the last 12 months? If you have diabetes (type 1 or 2) have you had trouble controlling your blood sugar (glucose) in the last 3 months? Do you have any other conditions that may require special consideration for you to exercise? Choose the appropriate response:* Choose the appropriate response is Required READY TO GO - I have ticked all of the Pre-exercise Health Screening questions CLEARED TO ATTEND – I have ticked one or more of the questions and have consulted my GP or appropriate allied health professional before undertaking physical activity/exercise. NOT CLEARED TO ATTEND – I have not been able to tick one or more of the questions and understand I will not be able to attend class until I have received guidance from my GP or appropriate allied health professional. I warrant that the details that are contained in this application are true and correct* I have read the Direct Debit Request and agree with the terms and conditions governing the debit arrangements between myself and Stripe* I have read and agree that we may handle your personal information in accordance with the Balance Minder Privacy Policy* Exclusion Notice:* Exclusion Notice is Required I am not a resident of South AustraliaI am a resident of SA and I have signed and emailed the below exclusion notice Are you a registered exercise professional? Please list where your registration is held and membership number.:* Are you a registered exercise professional? Please list where your registration is held and membership number. is Required Pre-requisite minimum Cert III in Fitness for Fitness Australia accreditation held in order to obtain CECs. Do you hold a Cert III in Fitness or higher?:* Pre-requisite minimum Cert III in Fitness for Fitness Australia accreditation held in order to obtain CECs. Do you hold a Cert III in Fitness or higher? is Required Yes No Do you hold a nationally recognised training qualification in Exercise for Children? :* Do you hold a nationally recognised training qualification in Exercise for Children? is Required Yes No If yes, please list details and upload copy below: If yes, please list details and upload copy below is not valid Do you hold a nationally recognised training qualification in Exercise for Older Adult? :* Do you hold a nationally recognised training qualification in Exercise for Older Adult? is Required Yes No If yes, please list details and upload copy below: If yes, please list details and upload copy below is not valid Please advise if you require any other assistance, to aid your learning experience: Please advise if you require any other assistance, to aid your learning experience is not valid Profession:* Profession is Required Personal TrainerPhysiotherapistExercise PhysiologistTai Chi InstructorNurseMental Health WorkerExercise ProfessionalOther Health/Teaching Professional Username:* Invalid Username Email:* Invalid Email Password:* Invalid Password Password Confirmation:* Password Confirmation Doesn't Match Password Strength Have a coupon? Coupon Code: Invalid Coupon We handle your personal information in accordance with the Balance Minder Terms of Service and Privacy Policy. I have read and agree this document.* No val Please fix the errors above
