Food-&-Body-Image-Burden-Releasing One-Day-Course
Thank you for expressing your desire to join the upcoming course/retreat for releasing burdens around food and bodyweight.
Sign in to Google to save your progress. Learn more
Email *
Please ensure you can make the times of both sessions of the course.  You will get the most out of the day this way. This retreat will be online and take place within one day, in two blocks.  Times of day: 9.30-11am EST / 2.30-4pm UK time and 12.30 - 2pm EST / 5.30-7pm UK time) (we take a break in the middle for individual rest and reflection: please try to keep this break time simple and spacious for yourself for maximum benefit). Please tick 'Agree' if you can make both sessions. *
Name *
Which date would you like to choose? *
Where did you hear about this course? (If Facebook, please mention the specific page) *
Please share a few words about your struggles with food and body-image (please note: this course is offered only for people who feel they have challenges in this area). The information you share with me here will be kept strictly confidential.
An official Welcome and Preparation email will follow in due course.  Meanwhile, feel free to reach out to me with any questions at  I am so glad we will soon have the chance to connect.  Very warmly,  Naomi
Please be aware that by enrolling on this course your email will be added to Naomi's mailing list where you will receive infrequent but friendly offerings and lovenotes about finding Food and Body Freedom.  You can of course unsubscribe at any time.  Thank you.
A copy of your responses will be emailed to the address you provided.
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy