Event registration
Dates & Times:  Weekly Sessions Fridays 8.30pm. Mondays 7.30am ONLINE.  Each session is 45-60 minutes.
Event Address: ONSITE - Flourish Movement Studio, Marketpoint, Mullingar & ONLINE via Zoom!
Contact: sheena@discoveringmindfulness.ie

You are welcome to attend single sessions or as many as you can each week and month.  The intention of these sessions is to offer a safe space where you can practice exercises to support your skills in grounding yourself in the midst of a world of uncertainty.  You will be able to integrate these exercises more skilfully in daily life with a commitment to a regular practice of mindfulness meditation.  It is also boosts effectiveness by practising with others and a guiding teacher.

Completion of this registration and advance payment is required before confirmation of a place.   You are welcome to join either onsite or online. Onsite places are limited each week to 6 seats to comply with current COVID-19 public health protocols. You can indicate on this form if you are seeking an onsite place or online place.  

All information given in strict confidence and held according to GDPR regulations (2018).

Thank you and I look forward to sharing this experience together.

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Email *
Telephone Contact
Name *
I am seeking a place that is *
What is drawing you these classes? *
Previous Experience of Mindfulness or Meditation Practice *
Have you ever experienced very difficult or unusual experiences in meditation, mindfulness or other similar somatic practices? *
Please advise of any significant health (physical and/or psychological) concerns for which you are receiving treatment/therapy currently or in the past?
I understand that I take responsibility for my self-care during this session and in abiding by the COVID-19 safety protocols of hand hygiene, physical distancing and coughing/sneezing etiquette. *
Required
Any questions/comments at this stage?
Liability Waiver
By submitting this form, I hereby retain Sheena Burke as my teacher for the guided meditation series at Flourish Movement Studio, Mullingar, from 20th July 2020. .

In participating in this course, I accept full responsibility for performing only those activities and moments that support and do not jeopardise my health and well-being. I understand that meditation may carry a risk of harm as does all activity and sign this retainer and liability waiver in agreement that Sheena Burke and videoconferencing application are not responsible for any loss, damage or injuries.

I understand that Sheena Burke is providing training, coaching, feedback and support in assisting me to become aware of my body’s inner wisdom.  My role at all times is to be awake to the message my body is sending me and to stop any activity or movement that may cause pain.

I understand that Sheena Burke is not diagnosing, prescribing or treating.  I agree to consult my General Practitioner about any concern I have about a state of illness, dysfunction or pain and to advise Sheena Burke about such concerns.

I confirm that I have read, understood and agree to the liability waiver for taking part in this course. *
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