Individual Workshop Registration Form -

Register: Mindful Parenting Workshop

Full Name *

Email Address *

Phone Number *

Emergency Contact Name & Number

For in-person participants only

How will you be attending? *

In-Person at Upprise Center

Virtual via Zoom

Select Your Payment Method *

Single Workshop – $45

Wellness Pass ($150 for 4 workshops)

Apply for Sliding Scale

What are you hoping to gain from this workshop? (Optional)

I understand that cancellations must be made 24 hours in advance for a full refund. *

I agree to maintain the confidentiality of other participants and respect the group space. *

I would like to receive occasional emails about future workshops and wellness resources.

You will be redirected to a secure payment page after form submission.