Gentle Touch Program Training Registration Form

THANK YOU FOR YOUR INTEREST IN THE Gentle Touch® PARENT-CHILD PROGRAM!

Training Topic: The Art of Gentle Touch®

Massaging children is an ancient tradition and communication process that has been rediscovered in this country. Research and clinical evidence show that loving, touching, and nurturing contact between caregiver and child has a positive impact upon the caregiver, the child, their relationship, the child's subsequent development, and the family.

Emma Miller D.Div., developed the Gentle Touch® Parent-Child Program in 1993. The Gentle Touch® Elements of Touch, Relaxation, Communication, Nurturing, Support, Information, and Celebration are effective with vulnerable populations. The unique Gentle Touch® Touch Continuum allows for touch that is appropriate for the health/emotional/developmental stage of the young child, and the needs of the caregiver.

Key features of the Gentle Touch® Parent-Child Program include prenatal/infant/child mental health, sensory integration, state modulation, and a family-centered, collaborative approach. Since 1994, trainees consistently report that information learned has a great impact on their professional and personal lives. Parents who then participate in this experiential parenting/health promotion/child abuse prevention program, in their homes or clinical settings, claim numerous positive benefits for their children, themselves, and their family as a whole.

This skill-based training will include lectures, discussion, experiential exercises, videos and other visual aids, handouts, child/family stories, and demonstrations. The class size will maximize interaction, and the supervised practice sessions will ensure proficiency. Participants are encouraged to network and bring situations pertinent to their work for discussion. A substantial manual will be provided for future reference. Optional supplies, including the Gentle Touch® Infant Massage Video, will be available.

A program abstract may be found on

http://www.gentletouchparent-child.com/PROGRAM-1-Introducing_GT.html

Presenter: Emma Miller, D.Div.

Developed the Gentle Touch® Parent-Child Program in 1993 with trainings since 1994 Authored/Co-Produced the Gentle Touch® Infant Massage Video

NC Infant/Toddler/Family Specialist

Certified in Pregnancy & Infant Massage

Dates: 3 days, Thursday through Saturday, April 29-May 1, 2004 OR September 16-18, 2004

Location: Conference Room

Wingate Inn

11 Rocky Ridge Road (Exit 2 off of Interstate 26, which is just off of Interstate 40)

Asheville, North Carolina 28806

PH: 828-665-4242

For specific directions, please contact the hotel directly.

Lodging: The hotel is located just 2 exits (approximately 7 miles) north of the Asheville Airport and across from the Biltmore Square Mall. The facility has a whirlpool, fitness room, business center, free local telephone calls, and an expanded breakfast bar. All rooms have a refrigerator, microwave, and Internet access. Reserve a room up until 30 days before the training for the special conference rate of $64.95 plus 11% tax. Thereafter, contact Kim Reece, Hotel Event Coordinator, to check on availability. Contact the Asheville Visitor’s Bureau for other lodging options, attractions, and events: 1-800-257-1300 or www.ashevillechamber.org or www.exploreasheville.com/index.htm

Registration: 8:00 AM- 8:30 AM the first day; room is open for networking and resources review thereafter at

this time.

Program: 3 days: 8:30 AM to 5:00 PM

Breaks are two 15-minute periods each day

Lunch is 1 hour each day (numerous restaurants within walking distance)

Registration, breaks and lunch offer great sharing and networking opportunities!

Participants are asked to bring a:

large (16"+), life-like doll and a cushion to sit on the floor,

plus a specific child/family situation pertinent to their work.

Audience: Professionals or paraprofessionals working in an intervention or supportive capacity with caregivers with children under age 5, for example, nurses, parent educators, lactation consultants, developmental disability specialists, early intervention specialists, special educators, early care and education staff, etc. Participants are requested to list experience with registration. Those without experience may inquire about an additional training module.

Credit: 21 contact hours; CEU's through Western Carolina University are available for $10.

A certificate of completion is offered for attendance and participation in the entire program.

Objectives: Trainings are always tailored to meet the needs of participants. That is, the objectives below can be modified to ensure that they are suitable.

This training will cover:

Ø The Gentle Touch® Touch Continuum,

Ø Applications to well parents with healthy children, and

Ø Modifications for children under age 5, and those parents and children with special needs.

Upon completion of the training, participants will be able to:

Ø Demonstrate proficiency in a series of developmentally sensitive touch & massage routines along the Gentle Touch® Touch Continuum

Ø List benefits of the Gentle Touch® Parent-Child Program including the benefits of touch, bonding, and attachment from a system perspective

Ø Identify prenatal/infant/child communication and behaviors

Ø Facilitate the child's self-regulation, and nurturing caregiving

Ø Plan Gentle Touch® Parent-Child Program interventions with various populations.

Fee: Early registration is discounted 5% and is $310 if received by March 24^th OR August 4^th.

Regular registration is $325 per person until the registration deadline of April 21^st OR September 1^st.

Please call for a discount if more than one individual from the same agency registers.

Agency purchase orders will be accepted with completed registration materials to secure a space, but payment must be rendered at the beginning of the training event.

Registration will be confirmed by email or fax.

Space is limited so early registration is encouraged to avoid disappointment.

Registration includes educational materials (including a substantial manual), instructor's training fees, refreshments during breaks, and a certificate of attendance.

Participants will be offered the opportunity to become certified and purchase optional supplies.

Note: This training, in and of itself, does not offer certification or the use of Gentle Touch® materials, nor does it qualify one to teach professionals. However, it is the basis for the certification that is offered via a continuing process. It will enable the participant to knowledgeably implement the Elements of the Gentle Touch® Parent-Child Program with young children and their parents in any setting.

Certification: Optional: There are two certifications available for this training. If participants wish to obtain one, they will need to complete a biosketch and required reading (1 pre-selected book and 1 choice pertinent to the certification) with feedback, and submit a videotape, certificate of insurance, and processing fee. The use of Gentle Touch® specialized materials and logo is available after training and demonstration of mastery of Gentle Touch® principles and practice. This may be of special interest to those without professional certifications. The fee varies upwards from $100, depending upon how long the participant takes to complete the process.

Payment: Checks can be made payable to "Gentle Touch Parent-Child Program LLC". International attendees please pay with a certified bank check.

Cancellations and Refunds:

If a particular individual cancels, and cancellation is received by telephone no later than 5 business days prior to the commencement of the program, the refund will be less 25% of the registration fee submitted. Substitutions from the same agency are permitted with submission of the registration material. If paid participants are sick or do not otherwise show during the entire training, they may attend a future training and their manual will be reserved for that time. If participants miss a portion of training, they may attend that portion of a future training. In this case, the attendance certificate will reflect the actual number of hours attended and they will be ineligible for CEU's through Western Carolina University. In the event of cancellation by the trainer, the refund will be 100%.

Faculty: Emma Miller, D.Div. Emma is the creator of the Gentle Touch® Program (1993). She is an international trainer and program consultant, conference speaker and workshop leader. Author of the Gentle Touch® Infant Massage Video (1996), as well as articles in professional, parenting, and massage publications, Emma has had numerous media exposures and program endorsements. She holds certifications as a N.C. Infant/Toddler/Family Specialist, an Infant Massage Instructor, a Nursing Child Assessment Satellite Training (NCAST) Instructor, and in Pre- and Perinatal Massage, and is an Interfaith Minister. Active in numerous organizations related to parent and child issues, Emma has worked in hospital, pediatric practice, mental health, substance abuse, developmental disability, child development, residential treatment facilities, social service, and family development institute settings. Her goal is to promote the early competence of the child, nurturing parenting, strong family life, and a responsive system of care. Her focus is on serving all families but especially “vulnerable” ones, prenatal and infant mental health, and family-centered practices.

Sponsorship: Agencies or individuals may wish to sponsor a closed (agency only) or open training in their

area. Please contact the trainer for information (1-888-333-3936).

***Registration Form Below***

REGISTRATION FORM

PROGRAM: The Art of Gentle Touch® (infants-preschoolers)

DATE: April 29-May 1, 2004 OR

September 16-18, 2004

LOCATION: Both in Asheville, North Carolina (please circle training you are registering for)

NAME:

JOB TITLE:

AGENCY:

WORK ADDRESS:

WORK TELEPHONE:

WORK E-MAIL:

WORK FAX:

HOME ADDRESS:

HOME TELEPHONE:

HOME E-MAIL:

HOME FAX:

WEB SITE?

EXPERIENCE with Children & Families: (attach resume or list separately; experience is required for this program)

Please copy this completed page for your records before sending it to:

Gentle Touch Parent-Child Program LLC

103 Cross Creek Circle

Sylva, North Carolina 28779 USA

Registration confirmation will be emailed or faxed.

______I plan to attend The Art of Gentle Touch® Training on April 29-May 1, 2004 OR

September 16-18, 2004 in Asheville, North Carolina (please circle)

Enclosed is a check/money order (payable to "Gentle Touch Parent-Child Program LLC") in the amount of __________.

I am applying for the following discount: early registration or multiple from same agency (circle).

______I cannot attend either of these trainings, but I may be interested in attending in Asheville, N.C. in 2005.

______I cannot attend this training. Please let me know when the next open training is scheduled near my area.

_____ I cannot attend this training but I can help arrange a training in my area in the future. Please contact me.

_____ Enclosed is $19.95 plus $5 S/H plus NC sales tax (payable as above) for one Gentle Touch® Infant Massage Video (not a substitute for professional training!).

Thank you for your interest in communicating Love through appropriate Gentle Touch®!