Summer Holidays Mindfulness Session for Children:

Your Details:

Name (required)

Telephone (required)

Email (required)

Please indicate time and date of the session you wish to book:

Please tell me your child's name, age and the school year they will go into in September:

Please tell me about any significant life events your child is currently experiencing e.g bereavement, family stresses, moving home, change of school etc:

Please indicate if your child takes any medication or has any allergies:

Payment:

Course Cost: £27

Full Payment is required at time of booking to secure your place.

Bank transfer (payable to: Co-operative Bank A/c 12306145 S/c 089103).
Please ensure you put your name and Mindfulness in the reference box so your payment can be identified.

Booking Conditions:

The following proportion of your fee, less a £5 admin charge, will be refundable if you cancel your place:

Up to 2 months before the start date: 100%

Up to 1 month before the start date: 50%

Less than 4 weeks before the start date no refund will be made.

The facilitator reserves the right to cancel the course under any circumstances. Should this be the case you will receive a full refund.

Signed:

Date:

If you have any queries about this form, or the course, please contact Gayle Creasey on 07941 279177

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