To take part in a Mind Diet workshop please fill in this form. Once we have received the form we will contact you to confirm your place.
The total price of the workshop is £99 including a very healthy lunch at Combe Grove Manor.

First Name


Last Name


*Gender
 Male
Female
  *Address line 1


Address line 2


*Town


*County


*Post Code
 
  Which date are you interested in? (please copy a date into the box)

September 20th 2007 at Combe Grove Manor, Bath
November 4th 2007 at Combe Grove Manor, Bath




 

What do you want to gain from the Mind Diet workshop?




 

What's stopping you from gaining this right now?



 

What have you tried that hasn't worked?




  *Email Address
  *Confirm Email Address
  Telelphone Number
 



*
How did you hear about us?




 

 

 

Disclaimer
Click here to read disclaimer

 

Cancellation of a booking is subject to the following terms:
Two weeks (14 days) prior course date – no charge
Less than two weeks prior the course date - total cost

Disclaimer:
I (the client) do assume all responsibility for my participation in The Mind Diet workshop. I am taking part with or without the approval of my doctor and do hereby assume all responsibility for my participation and any changes I make to my diet or activity level. I release The Mind Diet representatives that advise me from any liability for personal injury or other damage I may sustain whilst engaging in any programme or activity suggested by them.

* I agree with the terms and conditions of this site

 




 




 

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