Form

Note:Do not use the 'Enter' or 'Return' keys to change fields as it will submit the form prematurely

First Name

Last Name

Street, PO Box

Suburb

State

Postcode

Phone (H) include area code

Phone (W) include area code

Mobile

Email

I found Openground through

GP/Health Professional Brochure Word of Mouth Advertisement in local newspaper

Occupation

Preferred Course

Camperdown, Monday NSW Waverley, Tuesday NSW Chatswood, Wednesday NSW Parramatta, Thursday NSW Melbourne, Vic Perth, WA Brisbane, Qld Distance MBSR

Which Term

Message to Registrar

Refund Policy

We are confident you will find our classes enjoyable and beneficial. However, we do understand there are times when you may need to drop a course. Our refund policy is to provide a full refund, less a materials/registration fee of $100, for requests made prior to the second class in a course series. Course fees will not be refunded after the second class begins, however, you may have a pro rata credit to take the class at a future time that works for your schedule. Please request the credit at the time you request to be dropped from a class.

To request a refund, please send an email to info@openground.com.au indicating your name, the name of the class, reason for the refund, and a phone number where you can be reached in case of questions.

Waiver

In applying to register for the Openground course, I hereby absolve and indemnify Openground and all their servants, agents, employees from all liability arising from injury or damage in connection with my participation in programmes provided by or in connection with Openground. I understand that Openground will be collating ongoing outcome measures on disidentified data collected from participants in Openground courses for quality control purposes.

By submitting this form I accept these conditions of enrollment