Venue Hire Inquiry Form

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Dear future and recurring partners,

Are we a match? In order to co-create a harmonious event for both you, your guests and our center we kindly ask that you fill in the below information about your event to provide us with as many specifics, details and desires so that we can move forward with clarity.

With gratitude,

Samyama Team

Email *

Record my email address with my response

Please provide us with your full name *

Please provide us with your email address *

What is your Social Media handle? (Instagram/Facebook etc.) *

Please provide us with your number (WhatsApp is the best form of communication in Indonesia, including country code starting with +xx) *

Is this your first time venue hire event at Samyama?
*

Yes

How did you hear about Samyama Mindfulness?
*

What is the name of the event you're planning to host at our center? (session, workshop or retreat title as advertized by you) *

What dates do you have in mind for your event at our center?

Please outline as many as you need -- format DD/MM/YY

Do you plan on having any sessions with increased noise level, such as dance, screaming or use of music above normal room volume levels?

Whilst we appreciate that noise can not always be predicted it is really helpful for us if you can give an indication of if and when you are planning activities which could be considered noisy. Sharing this information with us will assist us in accommodating you during your stay with us.

Yes

Use of music

Catharsis/release/screaming

Dancing or Singing

Drumming or other musical instruments

Other (pease specify)

If you are expected above normal noise levels for your retreat, please indicate dates and duration.

Example: shaking meditation on October 12th from 10am to 11am.

Are you planning to offer or include any of the following substances in your event? *

Yes

Alcohol

Tabacco

Cannabis

Synthetic drugs

Hallucinogens

Prescription opioids or anabolic steroids

What halls and rooms would you like to rent? *

Dhyana Hall (capacity for ca. 30 people)

Akasha Hall (capacity for max. 15 people)

Dormitory (sleeps 4)

Mindfulness rooms (3 rooms, 3-5 people capacity)

Villa (2 master rooms + 2 mezzanine areas with pool and full kitchen)

Cottages (5 cottages with AC and private bathrooms)

Required

How many people are you expecting to attend your event *

less than 5

5 - 10

10 - 15

15 - 20

20 - 25

25 +

Will you require the use of our other facilities? *Please note these may require external facilitation. Not to be used unsupervised. If you're interested please inquire within.

Yes

Ice bath (1 person)

Ice bath (5 people +)

Steam room

Treatment room (massage, sound healing)

Clear selection

Do you require meals for your event? *

Yes, one meal per day (breakfast, lunch or dinner)

Yes, 2 meals per day (breakfast, lunch or dinner)

Yes, 3 meals per day (breakfast, lunch and dinner)

Yes, but not catered. My participants can order al la cart off your menu

Not sure yet, I will let you know well in advance.

Would you like to rent any additional services:

Yes

Maybe

Whiteboard

Sound System

Microphone

Projector

Flower Mandala

Clear selection

Clear form

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