Hold Me Tight Course Registration Form
We want you to get the most our this course. This course is intended for couples in committed relationships. If your relationship is in crisis due to addiction, domestic violence, undergoing psychological treatment or due to the impact of an Affair or if you have any other concerns regarding suitability please contact us prior to applying.

This is a couple course which includes doing exercises with your partner. It's important that you both plan and commit to attend all sessions. If due to unforeseen circumstances one of you is unable to attend during the course we will do our best to accomodate.

We will keep your information confidential .
Our Office Address and Contact is : Richard Cole - 41 Brunswick Place, Hove, BN3 1ND Tel: 07789 433 234

Course Applying For *
Where Did You Find Out About This Course? Please name the venue where you saw the flyer, the person who told you about it or the website name:
Your answer
Your Name *
Your answer
Your Email *
Your answer
Your Phone Number *
Your answer
Partner's Name *
Your answer
How Long Have You Been Together?
Your answer
How Would You Describe Your Relationship Now? *
In Crisis
As A Couple What Do You Hope To Gain From Attending This Course?
Your answer
Here Is Space If There Is Anything You Think It Would Be Important For Us To Know
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service