New Client Information (meditation class)

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Name *

First Name

Last Name

What would you most like to feel in 2025: *

Select up to 5

Grounded

Vitality

Connected to self

Connected to others

Satisfied

Joyful

Strong

Grateful

Balanced

Optimistic

Confident

Free

Have you done meditation before? *

Yes

Yes, as part of a yoga class

Yes, I've used apps/guided meditation

No

Would you like to be kept in the Project Soul loop and receive the quarterly newsletter? *

Yes please

No thanks