Vedic Meditation Course Registration Page Please complete the form below Name of Course Participant * First Name Last Name Email * Contact Phone * (###) ### #### Your Location * Date of Birth * MM DD YYYY Age * Occupation * Course Location * Auckland Hawkes Bay Wanaka Christchurch Other Course Date * MM DD YYYY Are you (or the course participant on whose behalf your are registering) currently under the regular care of a medical practitioner for anything other than general health?: * Are you (or the course participant for whom you are registering) currently taking any prescribed medication or do you (or they) have a history of medical problems (pls list - including mental health/PTSD): * Emergency Contact * Why do you (or the course participant) want to learn Vedic Meditation? * Do you have a preferred pronoun you would like to share? He/Him She/Her Them/They Is there anything else that Georgia should be aware of which may benefit her in teaching you to meditate? Thank you!
