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* 1. What is your first and last name?

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* 2. I am attending the retreats in the following location:

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* 3. I am interested in sharing lodging accommodations with another member of my co-hort during my in person retreats? ( A hotel room, an Airbnb, etc. A list of those interested will be compiled after registration closes.) 

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* 4. I understand that my monthly supervision may not be enough to cover my supervision needs and that I am responsible for making sure that my supervision needs are met.

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* 5. I agree to stay in compliance with all governing boards that oversee my work with children.

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* 6. I agree to maintain current malpractice insurance.  If for some reason, I do not need to carry my own insurance I agree to discuss this with my supervisor.

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* 7. I agree to the following refund policy: Full refund (minus cost of any pre-Certification supervisions that may have occurred + a $100 administrative fee) if cancellation is before 6-weeks from the start of your first retreat. Cancellations after this time and 6-weeks before the start of the first retreat will forfeit cost of any pre-Certification supervisions + $500 (USD) or $600 (AUD). Cancellations once the class begins will forfeit the full payment of the course. If an emergency situation arises, please contact the Synergetic Play Therapy Institute to discuss the situation.

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