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MBCL Foundation Course Registration

Are you currently a member of the MTAI?

Are you currently a member of the MTAI?
A
B

Firstname

Lastname

Email Address

Mobile Number

City / Town

Home Address

Emergency Contact Number

Please select prior mindfulness courses and dates that you have attended to demonstrate that you meet the pre-requisites for this event (please check the requirements to attend in the description document)

Please select prior mindfulness courses and dates that you have attended to demonstrate that you meet the pre-requisites for this event (please check the requirements to attend in the description document)

Do you have any physical difficulties that make sitting, standing, walking or doing any simple exercises difficult for you?

Do you have any physical difficulties that make sitting, standing, walking or doing any simple exercises difficult for you?
A
B

Do you have any mental or physical health issues or concerns, or have you experienced recent challenging life events that would be useful for the trainers to know about?

Do you have any mental or physical health issues or concerns, or have you experienced recent challenging life events that would be useful for the trainers to know about?
A
B

Are you currently taking any medication?

Are you currently taking any medication?
A
B

Are you happy to work alongside others in breakout rooms?

Are you happy to work alongside others in breakout rooms?
A
B

Is there anything else you think it would be helpful for the instructors to be aware of?