Family Mindfulness Booking Form
We are so happy to book your family onto a session, please answer the questions below and we will contact you with full details of date, time and how to join the Zoom.
Name
First Name
Last Name
Names and ages of children attending the session
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
What are your reasons for joining the course? E.g calm anxiety, release tension...
On a scale of 1-5, 1 being no stress, 5 being highly stressed, how would you rate your stress levels right now?
1
2
3
4
5
No stress
Highly stressed
1 is No stress, 5 is Highly stressed
We will process the personal information on this form to enable us to deliver and monitor this project. We will delete all personal information 6 months after the end of the project. We will also share the information and feedback with Phoenix Community Housing Association so they can: • Monitor this project to ensure it benefits Phoenix Community Housing Association residents • Carry out anonymised research• Maintain their accounts and records The information you provide will be stored and retained securely and treated in accordance with Phoenix Community Housing Association and Jelly babies Data Protection Policies, the General Data Protection Regulation and any succeeding acts. More details about how Phoenix Community Housing Association uses your data can be found in their data protection policy www.phoenixch.org.uk or on request by calling 0800 0285 700.
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