Book

now

Register

Course information.

All fields marked * are required.

Course*
Please select your course

5-day MSC dates*

Please select your dates

MSC 5 Day Non-residential Intensive 23rd to 27th of April 2020

Please make your selection

MSC 5 Day Non-residential Intensive 9th to 13th of July 2020

Please make your selection

Retreat Day dates*

Please select your dates

Retreat Day Saturday 13th June 2020

Please make your selection

Retreat Day Saturday 1st August 2020

Please make your selection

Retreat Day Saturday 3rd October 2020

Please make your selection

Retreat Day Saturday 5th December 2020*

Please make your selection

MSC: Inner Resilience - 20th of October, 10am - 4pm*

Please make your selection

Creating Balance - 3rd of November, 10am till 4pm*

Please make your selection

Registration Data

First Name*
Please let us know your first name.

Last Name*
Please let us know your last name.

Age (Optional)

Contact Number*
Please let us know your Contact Number.

Preferred contact time
Invalid Input

Your Email*
Please let us know your email address.

Postcode

Do you have any special conditions to be catered for (e.g. dietary, accessibility, etc.)?

Payment Details

Fee type*
Please select your fee type

Fee type*
Please select your fee type

Preferred payment option *
Please select your fee type

If you are applying for a concession rate, please share a little about your current circumstances

Further Information only for MSC Programs

If you are registering for a retreat day or workshop, this information is not required.
What interests you about the program and what are you hoping to gain?

Can you make the commitment to attend all sessions?
Invalid Input

Can you make the commitment to practice the mindfulness and compassion skills in between each session?
Invalid Input

Compassionate Choices

I agree to print and complete the following Compassionate Choices form
Invalid Input

Click here to download the form.

Emergency contact name and mobile number.

Please share details of any previous meditation experience

Please note any current mental health problems or significant life issues you are experiencing

If so, are you under the care of a mental health practitioner?
Invalid Input

Additional Information

Are you happy to subscribe to our quarterly newsletter?
Invalid Input

How did you hear about Adelaide Mindfulness?

Please include any comments or questions you may have

Privacy Policy & Terms and Conditions

We value our community and ensure the data we collect is handled sensitively, securely, and with due regard for personal privacy. We will not release your email address or personal information to any other party.

Submission of this registration form is not confirmation of your position in the program/ workshop. We will be in touch with you shortly to confirm your place and discuss payment details.

Captcha*
Captcha
  RefreshInvalid Input

adelaide-mindfulness-logo-white.png
Compassion-Based Mindfulness Programs and Workshops:
Creating and delivering individual sessions or group training in Mindfulness, Meditation, Compassion and 
Self-Compassion to manage problematic stress and anxiety.
© 2020, Adelaide Mindfulness