Class Interest & Registration Form: Mindful Tweens & Teens
Tweens and teens will use techniques of mindfulness to intentionally focus awareness and observations of their own emotions and behaviors from moment to moment. Together, we will explore how we are as individuals and what it means to be part of a larger community.

The standard fee for participating in the program is $195.  Payment is to be received before the group starts and is paid directly to the facilitator.  Scholarships are available on a case-by-base basis.

Even if you know exactly which group you would like to join, it would be helpful for us if you include your full address and fill out the other questions, in the event that the group you want is full.  
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Parent Name (First and Last) *
Child Name (First and Last) *
Child Birthday *
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eMail Address *
Phone Number *
Please indicate home (h), cell (c), or work (w)
Address *
Please include your entire address, it helps us suggest alternative placement if we have more than one option available.
Additional Information
Please feel free to tell us additional information about your child(ren)
Group Information
Please answer the questions below even if you know the group that you wish to attend. This will assist us in the event we are unable to place you in that group.
Session
If known
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DD
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Further Details:
Please provide additional details that might help us place you in a group or with a facilitator
How did you hear about this program?
What do you hope to gain from this program?
Legal Disclaimer
Withdrawal from a Group: Because each leader is paid by the participants in the group, we cannot issue a refund if you decide to withdraw from a group after the point in time that is 24 hours prior to the group starting.

Employee Assistance Program Benefits: Your company or your spouse’s company may provide payment to Finding Calm through an EAP. If your company wants to talk with the Community of Mindful Parenting about creating an Employee Benefit, please have them contact us. Withdrawal rules apply as above.

Confidentiality: No information about you is released from Community of Mindful Parenting to anyone without your written permission, except as required by law or court order. We are required by law to report suspected child abuse (regardless of when it occurred), elder abuse and, clear, concrete evidence of planned acts of violence.

Grievance: If you have any concerns or complaints about your Community of Mindful Parenting group participation, address the issue directly to your group leader(s) first. If the issue is not resolved to your satisfaction, feel free to direct your concerns to the Community of Mindful Parenting office either via email or phone.

Contact information:
Email: info@communityofmindfulparenting.com 
Website: www.communityofmindfulparenting.com 
Phone: 206-829-2660
Legal Disclaimer *
Required
Full Name
I have read and understand my rights and responsibilitites as defined above
Discount Code
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