Day of Mindfulness Application Form
Name *
Your answer
Phone Number *
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Email Address *
Your answer
Date of Course you wish to attend *
Your answer
Any previous experience of mindfulness/meditation? *
Your answer
Any Physical, Mental or Emotional difficulties that you would like me to be aware of? *
Your answer
Do you have any physical difficulties that may make gentle yoga difficult for you? *
Your answer
How did you find out about the course? *
Your answer
Any other information you think would be important for me to know
Your answer
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