Mindfulness Practice Day - Sun December 11th 2022

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Use this form to register your interest in attending this day of practice. The information you enter is solely for the course tutor. Confirmation of your place will be sent by email. If you have any questions email info@mindfulinthecity.co.uk

First name *

Last name *

Mobile telephone number

Please select from the following *

Email *

Which sessions do you intend do join? *

All sessions

Early morning session 08:00 - 08:40

Morning session 10:00 - 11:15

Afternoon session 15:00 - 16:00

Evening session 19:45 - 20:45

Required

PLEASE READ: This day is designed for people who want to find ways of working with stress more effectively. It gently encourages moving towards experiences (including difficulties) in order to be able to work with them more skilfully. This can be challenging as well as rewarding. If you have a current mental health issue such as severe depression or PTSD, or are in a period of major life challenge such as recent bereavement, active substance addiction or trauma, a Mindfulness day may not be right for you at this time. Please check the appropriate box *

I feel ready to participate in this day of practice

I do NOT feel ready to participate at this time

I would like to discuss this privately with the tutor

Other:

Have you read the Practice Day Information Sheet" including the "Ground Rules" ? Read here: https://mindfulinthecity.co.uk/practice-day-info *

Yes, and I accept the "Ground Rules"

Please describe any physical illness or other limitation that may make sitting, standing or physical movement difficult for you:

Please describe any sensory impairment (e.g. sight or hearing) which you would like the tutor to to be aware of:

Is there anything else (e.g. neurodiversity) you would like to make the tutor aware of?

Please indicate your level of experience:

I have attended a 4 or 8 week course with MITC (Bob Chase)

I have undertaken mindfulness/meditation training elsewhere

I am self taught but feel experienced enough to participate

Other:

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Data Protection and communication consent

The information you provide will be kept confidential and will NOT be shared with anyone other than the tutors. It will be deleted at the end of the course. By clicking SUBMIT you are consenting to receive communications from and about MITC and its courses. You can unsubscribe at any time by emailing unsubscribe@mindfulinthecity.co.uk

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