Kink and Swamp January 2023 - NOW FULL - Register for the waiting list- We usually have one person drop out

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All information will be kept confidentially.

Email *

Full Name *

We try and have a spread of gender, race and age. To help us do this please share your identifiers, as you feel comfortable. Eg. Male, White, mid thirties, Heterosexual

Where do you see yourself on the Kinsey Scale of sexuality

0: Exclusively opposite sex/heterosexual behavior or attraction

1: Predominantly heterosexual, but slightly inclined to be attracted to the same sex or engage in homosexual behavior

2: Predominantly heterosexual, but more than slightly inclined to be attracted to the same sex or engage in homosexual behavior

3: Equally heterosexual and homosexual behavior or attraction

4: Predominantly homosexual, but more than slightly inclined to be attracted to the opposite sex or engage in heterosexual behavior

5: Predominantly homosexual, but slightly inclined to be attracted to the opposite sex or engage in heterosexual behavior

6. Exclusively same-sex/homosexual behavior or attraction

X: No socio-sexual contacts or reaction/asexual

Other:

Clear selection

Telephone number (we will call you to arrange the workshop)

Which Workshop(s) or Course(s) Are You Signing Up For? (double checking) *

WORKSHOP IS NOW FULL - Register for the waiting list (Don't pay and type 'waiting list'). To confirm booking please pay here with your name in the reference: Paypal: (please pay me 'as a friend' to avoid fees from PayPal) - Paypal.me/neilmorbs or neilmorbey@gmail.com Or by Bank Transfer: Natwest Bank: Mr Neil P Morbey Sort Code: 56-00-63 Account: 41294807

WORKSHOP IS NOW FULL - Register for the waiting list (Don't pay and type 'waiting list'). How much have you paid? By Which method (PayPal/bank)? *

Hopes and Fears: What would you like to gain or work on? What concerns do you have?

Do you feel you have any health conditions, (phobias, emotional-traumas, triggers, allergies, disabilities or injuries) that may be helpful to tell us about? Please let me know any needs, or ways I might be able to make it easier for you.

If not, leave blank

The satisfaction in my work comes from helping people to achieve their main goal. This only works if you do - If you are willing to practice, which is why I ask people to, literally , sign up to the following:

Check all of these if you agree to: *

Come to the sessions or cancel 48 hrs in advance (or it may not be possible to refund you)

Let us know if you are having difficulties, and ask questions - to be engaged in your learning.

Look after yourself throughout, tuning into your capacity and needs (this includes asking for help in a timely manner).

Schedule time after the workshop to process, integrate and make space for vulnerable feelings. Check out my blog on 'Emotional Drop'. https://www.positively-mindful.com/blog/dealing-with-the-emotional-drop

Required

Emergency Contact (Just in Case - Name, number, relationship) Eg. Sally Smith, 0745885588, Mum. *

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