Name
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First Name
Last Name
What are your pronouns?
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Email
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What are you most hoping for/envisioning for your time with Lore?
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Please share your goals, interests, etc.
Which of Lore's services are you most interested in exploring?
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Movement coaching
In-depth exploration of yoga asanas
Education on body anatomy & function
Mindfulness practices, breathwork, and meditation
Reiki energy healing
Movement and/or mindfulness as tools to experience gender affirmation and gender euphoria
Dismantling the internalization of -isms (i.e. cissexism, sizeism, ableism, racism, heterosexism, and sexism)
Hedge witchery, ancestor work, Tarot, and/or green witchcraft
Accessibility and diversity consultation services for businesses, organizations, schools, and fitness facilities
Herbalism-related topics
Discussions related to growing, foraging, preparing, preserving, and/or sharing/distributing food
Having Lore facilitate a presentation or discussion
Are there other areas you'd like to explore?
Do you have any particular areas of concern?
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Do you have any accessibility needs?
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Is there anything else that is important for Lore to know about in regard to the reason(s) you are reaching out?
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Do you understand that Lore is not a typical personal trainer, that our time together may or may not involve challenging movements (or even any movement at all, depending on your goals and needs in any given moment), and that if it does the focus will be more on building your knowledge about and independence in movement rather than on intensity for intensity's sake?
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Yes
No
Positive Force Movement/The Wild Within is an overtly pro-fat, pro-LGBTQ+, anti-ableist, anti-racist space, and the team of PFM deeply believe that embodied empowerment is one aspect of encouraging social, community-based, and political transformation. Do you have any questions or concerns about this?
What's your schedule availability?
Weekday mornings (7a-noon EST)
Weekday afternoons (noon-4pm EST)
Weekday evenings (4p-8p EST)
Saturday mornings (7a-noon EST)
Saturday afternoons (noon-4p EST)
Is there any additional relevant scheduling information?
(i.e., Specific days or times that are or are not available for you)
Would you need scholarship funds to cover the cost of your work with Lore?
Yes, partial scholarship coverage, short term (1-3 months)
Yes, partial scholarship coverage, for the foreseeable future
Yes, full scholarship coverage, short term (1-3 months)
Yes, full scholarship coverage, for the foreseeable future
No
No, and I would like information about donating to the scholarship fund