Meditation Course Booking Form Meditation Course Booking Form Name * Phone Number * Email * Postal Address * Date of Course * Location of Course * How did you hear about the course? Have you done any meditation before? Is there any physical injury/condition your instructor should know about? Are you currently or have you in the past experienced anxiety, stress or depression? (All information provided is held in strict privacy) Disclaimer: I confirm that I am participating in a mindfulness meditation course during which I will receive information and instruction about meditation and health. I recognise that any information and advice shared during this class by the teacher does not replace professional medical advice. * Please tick here to confirm you have read and understand the Disclaimer To help us try and cater for everyone please indicate here if you have any special dietary requirements Eg. Allergies, vegetarian, vegan or gluten free Submit If you are human, leave this field blank.