Workshop Enrollment Form
Thank you for your interest in Mindfully Raising Children Without Overwhelm. To make sure this is the right program for you, please answer a few short questions.
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Email *
Name *
Today's Date
Please choose your top two goals. *
On a scale of 1 - 10, How confident are you in achieving the goals chosen above if you have the right type of support? *
Not much, I feel these goals are not possible
I am ready to do what it takes
What qualities do you wish you had more of as a parent? *
What is in the way of you regularly expressing these qualities? *
My child or children have the following diagnosis. *
If there is anything else you would like to add about your situation, challenges, or goals, please share below.
The live workshop will start on Thursday, March 10th. Please mark below how and when you would like to participate. If you need assistance in finding what time the workshop runs in you live, go to *
Please check the age(s) of your child(ren).
Where will you be joining us from? (city & country)
How did you learn about this workshop
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