BOOK, REGISTER & PAY

Name *

First Name

Last Name

Date of birth *

MM

DD

YYYY

Phone number *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do any of the below apply to you?

I ask this to make my sessions as accessible as possible.

High or low blood pressure

Anxiety

Restricted mobility

Hearing impairment

Partially sighted

Other

None of the above

Do any of these apply to you? *

Student’s responsibility – Meditation is a safe and effective stress management tool. However, if you have any of the conditions listed in this question or are under supervision by the mental health team/health care provider, we will require you to obtain consent from them to attend this class.

Under supervision with mental health team/healthcare provider

Depression

Bipolar

Schizophrenia

Epilepsy

None of the above

Tick to confirm the below in line with GDPR/personal data: *

I give permission for my details in this form to be kept on file (safely stored in line with GDPR regulations) for the duration that I attend classes/courses/events with Watch the Sunrise.

I confirm the details I have given on this form are correct.