Registration Form 2022
I feel deeply honoured to share this journey of self-discovery & self-care with you and your daughter.

Her wellbeing is and will always be my highest priority and, to support her in the best possible way, it is important to know if any health, emotional or family issues are present.

Please take some mindful time to complete this form, it will give me so much insight to plan my sessions in alignment to what the girls really need. Know that all information will be handled with care and will be kept strictly confidential.

Thank you for your trust and openness.
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Email *
Your daughter's name *
DOB *
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School Grade in 2022 *
School in 2022 *
School Camp Starting Date 2022 (if known)
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Your daughter's email *(Required for Teens)
Emergency Contact (Name) *
Emergency Contact (Mobile) *
Emergency Contact (Email) *
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