mother & daughter series at Namaste Yoga and Wellness
Family Questionnaire – Tell Rebekkah a little more about you and your child.
All answers are confidential and will be read only by your instructor, Rebekkah.
Fill out form and Submit
[contact-form][contact-field label=’Name’ type=’name’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Phone’ type=’text’/][contact-field label=’How much mindfulness/meditation experience do you have? ‘ type=’radio’ options=’New,1 year,2-5 years’/][contact-field label=’Childs name’ type=’text’/][contact-field label=’How much mindfulness experience does your child have?’ type=’radio’ options=’New,1+ year’/][contact-field label=’Describe what you enjoy (or might enjoy) about practicing mindfulness/meditation? What do you think your child enjoys (or might enjoy) about practicing Mindfulness?’ type=’textarea’/][contact-field label=’What is challenging for you about your mindfulness practice? What is challenging for your child about mindfulness?’ type=’textarea’/][contact-field label=’What area of your life and your child%26#039;s life do you most want to bring mindfulness to during our series?’ type=’textarea’/][contact-field label=’Additional comments or questions: ‘ type=’textarea’/][/contact-form]
Learn More
Questions? Please contact: info@rebekkahladyne.com or 415.939.7937
Also see the blog and tools tab for home practice CD’s, podcast and mindfulness articles.