Surfing the Wave

APPLICATION FORM

November / December 2024

3 Day Holiday Workshop

Mindfulness Skills - Training our mind to stay in the present moment.
Emotion Regulation Skills - Learning to manage those big colourful emotions.
Distress Tolerance Skills - Handling the trickiest situation gracefully.
Interpersonal Skills - Becoming a master communicator.

This workshop is funded for rangatahi aged 12 to 24 living in the Counties Manukau area.
Dates to be confirmed for November and December 2024, 9am to 3pm with lunch provided.

Name

First Name

Last Name

Pronouns

Date of Birth

NHI Number (if known)

Ethnicity

Current Address and Suburb

Phone Number

Why are you interested in joining this group?

How did you hear about this group?

Do you have any food allergies?