Mindful Me Registration Form
A 4-H Primary Mindfulness Curriculum
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First and Last Name of Youth Participant
Age of youth participant(s)
First and Last Name of Parent/Guardian
Indicate which sessions you would like to attend
Mindful Eating -Tuesday, August 25 @ 10:30 am
Affirmations - Tuesday, September 1 @ 10:30 am
Mood Management - Tuesday, September 8 @ 10:30 am
Smile Tag - Tuesday, September 15 @ 10:30 am
Describing Feelings- Tuesday, September 22 @ 10:30 am
All of the above
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