Registration form for CME course

Cuevas MEDEK Exercises (CME) CME I: November 30 to December 4, 2009

SPONSORED by Albemarle Therapy Center and blueballoon Health Services
Instructor: Simona DeMarchi, PT, CME IV Certified Practitioner


Name: _________________________________________________________________________

Address:_______________________________________________________________________

Telephone No: (Home)_____________________________ (Business)___________________________

E-mail address:___________________________________Profession: __________________________

Place of Employment:___________________________Insurance Policy # _________________________________

Course fees (Please circle one):
�CME I:$1250 + GST of $62 (Includes 5 days of instruction and refreshments for all breaks. Lunch is not included) Please bring a doll for practicums. Models will also be available for practicums.

I WILL / WILL NOT (please circle) be attending Day 5 of the course and WILL / WILL NOT (please circle) be able to utilize one of my clients. Please refer to attached schedule for further details regarding Day 5 of the CME courses. If you are planning to attend Day 5 AND are able to bring one of your own clients, please contact Molly Zarski at 434-979-8628 or 434-962-4148, Albemarletherapy@Embarqmail.com regarding scheduling for your client.

Payment information:
o Payment options:

By Cheque or US money order made payable to blueballoon Health Services and mailed, with a completed registration form to:

blueballoon
Attn: CME Registration 2009
37 The Links Road
Toronto, Ontario, M2P 1T7
Email: cme.registration2009@blue-balloon.com

o Payment due in full in order to confirm registration
o Registrations will be accepted/courses will be filled on a first come, first serve basis
o Max # of registrants per course is 12
o Receipt will be included in registration package or emailed upon payment
o Confirmation of registration will be the PAID invoice
o blueballoon has the option of canceling the course due to lack of attendance

o LIABILITY INSURANCE. All participants in the course must have liability insurance. Please provide your policy number on the registration form. Please note that you will also be required to bring proof of liability coverage with you on the first day of the course.


o NOTE: UPDATED CANCELLATION POLICY: If cancellation of registration is necessary, a cancellation fee of $50 will apply. No refund within 14 days of start of each course i.e. November 16, 2009

Registration deadline November 16, 2009



TENTATIVE COURSE AGENDA

Monday
8:30 - 9:00 Registration

9:00 - 11:00 Introduction to CME
11:00 - 12:00 CME I dexterity test
12:00 - 1:00 Lunch
1:00 - 2:15 Demonstration of CME assessment (followed by 15 minute break)
2:30 - 4:00 Practicum for CME assessment

Tuesday
9:00 - 10:15 Demonstration of CME I head control exercises (followed by 15 minute break)
10:30 - 11:30 Practicum for CME I head control exercises
11:30 - 12:00 Interactive review with dolls
12:00 - 1:00 Lunch
1:00 - 2:15 Demonstration of CME I trunk control exercises (followed by 15 minute break)
2:30 - 3:30 Practicum for CME I trunk control exercises
3:30 - 4:00 Interactive review with dolls
Wednesday
9:00 - 10:15 Demonstration of CME I standing control exercises (followed by 15 minute break)
10:30 - 11:30 Practicum for CME I standing control exercises
11:30 - 12:00 Interactive review with dolls
12:00 - 1:00 Lunch
1:00 - 2:15 Demonstration of CME I walking control exercises (followed by 15 minute break)
2:30 - 3:30 Practicum for CME I walking control exercises
3:30 - 4:00 Interactive review dolls
Thursday
9:00 - 11:00 Review of CME assessment and creating a treatment plan (done in groups)
11:00 - 12:00 Group presentations
12:00 – 1:00 Lunch
1:00 - 3:15 Interactive review of all CME I exercises with dolls (followed by 15 minute break)
3:30 - 4:00 Presentation of diplomas and wrap-up of the course

Friday is optional attendance with registrants invited to bring a current client for a 45 minute session. During each session, the treating therapist will be asked to propose CME I exercises that they think would be appropriate for their client and to try those with the child under my direction. Depending on the number of sessions scheduled and the number of registrants in attendance, another therapist from the group may be invited to join the treating therapist at the front of the room for his/her session. All others are to observe quietly. Sessions will begin at 9:00 am and will run every 45 minutes until 11:15 (taking us to 12:00 for a lunch break). If necessary/sufficient interest, we can then resume at 1:00 with additional afternoon sessions, again every 45 minutes.