iRest for Emotional Resilience : A 5-week Series

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Please complete this form to register for the upcoming online series. Following completion of this form, you will need to send payment via one of the two options indicated. Once payment is received, you will receive an invite with zoom link for the entire series.

Please contact Jen directly if you would like to request a reduced fee or note it as a question on this form.

Name *

Address *

City, State ZIP *

Mobile Phone Number *

I am interested in this series because I'd like to *

Better understand and respond to emotions

Experience and learn more about iRest

Relieve stress and anxiety

Create more resilience

Improve sleep

Experience more peace and ease in my life

Other:

Required

I would describe my experience with mindfulness meditation (any form) as *

NEWBIE : I've meditated only a few times or not at all

DABBLER : I've tried meditation a few times

SOMETIMER : I practice sometimes, off/on or inconsistently

MEDITATOR : I practice consistently, most days

I am a current client or student of Jennifer Anderson. *

Yes

I prefer to pay for the series ($115) utilizing *

Venmo (@Resilience-Yoga)

Check (made out to Resilience Yoga Therapy)

My partner/family member (living in same household) will join me for this online series.

NOTE: No additional charge.

Yes

Maybe

Please share any questions.

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