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Spiral Movement Center

Adapted Spiral Praxis Intensive Intake

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Welcome to the ASP Intensive—we hope that your stay with us will be enjoyable and transformative for your child! Please follow the steps below to ensure that your trip to Spiral Movement Center is smooth and enjoyable. We look forwards to hosting an adventurous intensive for your child!

Step 1: Submit Assessment Videos

Assessment videos are 100% confidential, will never be shared with anyone, and will be accessible to you post-intensive to record your child’s progress. Please use the free, no-sign-up service WeTransfer to send your videos/photos to us. Send videos that demonstrate your child's current motor abilities as well as sitting, standing, and crawling postures. Videos showing your child's personality and behaviour in everyday tasks are also welcome.

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Step 2: ASP Permission Form

All families must submit entry data for their child. This form also includes important information about our privacy and refund policies and video consent. Please fill out this intake form as completely as possible.

I. Personal Information

Participant's Name

Parent / Guardian's Name

Address

Phone *

Emergency Contact Information

Additional contact #s such as cell phones can be listed below

II. Background Information

Please provide a brief summary of your child's condition *

Please list any medications your child is taking. Please indicate if no medications are taken. *

Are there any special medical concerns (e.g., seizures, medications, food allergies, other?) *

Does the participant need assistance with toileting? *

Has your child ever been physically violent (hitting, kicking, scratching, etc.)? *

Will the above named participant be traveling to and from Spiral Movement Center alone? *

III. Video and Photography Consent

Over the course of the intensive, sessions are often videotaped to monitor a child’s progress and to record motor activities for archival purposes. The footage may also be used for general education and awareness including for conferences, presentations, websites, and social media. Some families will also be asked to participate in a documentary project to record their child’s intensive alongside parent/caregiver interviews. I hereby grant to Spiral Movement Center the right to use raw footage of the intensive for the purposes above. Parents who agree to these terms will also receive said footage upon request.

IV. Participant Release Form

I accept responsibility for my child's own medical coverage. I hereby give permission for staff/ volunteers of Spiral Movement Center, to arrange for any emergency medical care including hospitalization and transportation if necessary, and agree to pay for all expenses and costs incurred thereby. If emergency medical care is required, attempts will be made to contact emergency contact person(s) shown above. I agree to release and indemnify and save harmless Spiral Movement Center, c.o. Yuji Oka and their staff from all claims arising from whatever participation in any program organized by the staff or volunteers of Spiral Movement Center by any cause whatsoever. Please note that this form with its legal consents and liabilities remains in effect from the date it is signed and will apply to any future Spiral Movement Center programs that the above-named participant is registered in unless advised otherwise in writing. I, the undersigned, have read and fully understand the "Participant's Release Form".

V. Refunds/Cancellation Policy

Due to the logistical requirements necessary for children’s intensives, we require that payment be provided well in advance of your arrival. All intensives are scheduled on a first-come, first-served basis. In the event of a cancellation, we will offer a full refund up to one month prior to the scheduled intensive, and a refund minus deposit up to two weeks prior. We will not be able to provide refunds after this period, except in cases of illness arising during the intensive, in which case a pro-rated cost will be refunded. All visiting families are responsible for all travel costs regardless of circumstances.

VI. Additional Needs/Requirements

If you have any additional needs or requirements, please let us know in the field below or by writing us at: info@adaptedspiralpraxis.com. We will be able to provide accommodation or adjustments depending on you and your child's specific needs.

Additional Needs/Requirements

Thanks for submitting!

Step 3: Choose Payment Option

Due to the logistical requirements necessary for children’s intensives, we require that payment be provided well in advance of your arrival. All intensives are scheduled on a first-come, first-served basis. Please select one of the options on the right to pay for your child's intensive.

Bank Transfer

Credit Card

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Interac

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PayPal

Step 4: Travel & Visa Information

Please enter your travel information to ensure a smooth travel experience. If you are arriving by plane with luggage that will fit in our compact car, we will try to pick you up at the airport!

I. Flight and Travel Information

Choose a time
Choose a time

II. Visa Requirements

All information regarding Canadian Visa requirements can be found on the Canadian Visa website. Normally our visitors apply for tourist visas, as medical visas are not applicable for somatic interventions. We can provide support letters on request.

Thanks for submitting!

Step 5: Accommodation Details

Download the zipped files to get more information about the intensive accommodations at SMC, parking and neighbourhood landmarks.

FAQ

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