Individual Registration

Please enter information in the form below to process registration for event Art Therapy Information Session .

First Name *

Last Name *

Phone *

Email *

Have you been taught a movement or meditation class by Róisín Kenny in the past 2 years? *

Yes

Reason for joining movement or meditation classes: *

Reduce Stress

Increase Strength

Improve flexibility

All of the above

Please tick the box(es) which apply *

I am pregnant

I have been pregnant during the last 9 months

I am breastfeeding

I have medical conditions or recent injuries or surgeries (enter info below)

None of the above

State medical conditions *

Opt in to our newsletter for more information and special classes

Yes

Amount

€

Payment Method

Stripe Checkout

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Holder Name*

By registering for this class, I accept Terms and Conditions