The Art of Meditation Registration Form

Name *

First Name

Last Name

Phone *

(###)

###

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you have a regular meditation practise? *

Yes

No

Are you currently a practitioner or professional in any related field? *

(e.g., yoga, therapy, coaching)

Yes

No

Do you have any access needs or health considerations (including invisible disabilities) you'd like us to be aware of? *

Yes

No

Will you be joining the optional in-person immersion day in London on Sunday, December 21st? *

Yes

No

Please confirm your commitment to tune into 21 days of online meditations and completion of the self-paced modules. *

I confirm my my commitment

Liability disclaimer *

I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in this course.

I agree