The Power of Gratitude In-Person Retreat Registration

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You can read all the details about the retreat and the schedule here.

We're grateful for your interest in the retreat. Siri and Ben are joyfully committed to creating the best experience possible for each participant, so please allow us to get to know you a little bit so we can offer the best teaching and guidance possible. This form takes about 10 minutes to complete.

We work with self-compassion, so please allow 2-3 working days for us to respond and confirm with you

Email *

Your Name *

Your phone or WhatsApp number *

How did you hear about this retreat? For example, through the teachers, a friend, online, etc.

Briefly describe your reasons for wanting to attend this retreat and what you hope to gain participating. *

Please describe your previous experience or training in mindfulness or self-compassion. If you have completed the MSC course or other SC workshops, please note that here. *

Have you ever attended a silent meditation retreat before? If so, please briefly list and describe the retreat(s) you have attended.

Do you have any current or recent physical, emotional or spiritual concerns that might make meditation difficult for you at this time? On meditation retreats, individuals may experience strong physical and emotional states at times. Please check any conditions below that apply so that we can support and care for you properly should this become a concern.

Drug abuse, dependence or addiction issues

Diagnosis or treatment of a mental illness

Medical conditions that could require attention during retreat

Other:

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Specifically, if you have recently experienced any significant life event, traumatic experience or major loss, it would be helpful to note that here , so that the teachers will be aware.

Do you prefer single or double occupancy? Please check out details about Kanokrat here
*

SIngle occupancy (6500 baht; same room as double occupancy but no roomate)

Double occupancy (4500 baht); I will share with someone else- the organizers will assign a roomate of the same gender for the retreat

Double occupancy; I'm registering along with the person I would like to share with (they will complete this form separately)

Other:

Name of other person I plan to share with (if applicable)

Do you need shared van to/from downtown Bangkok? (there is an additional charge of 1000 baht round-trip for this service) *

Yes

Is there anything else that would be helpful for you to share with the teachers at this time?

Thank you for taking the time to complete this form. The teachers will be in touch to respond to any questions you may have included here or if they would like to follow up on any information you provided.

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