10 Day Retreat Registration Form 2020
Please complete the registration and medical form.  This is needed, along with your deposit to ensure your reservation.  Please know that it is strictly confidential and this information is only used in case of an emergency.
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19th-28th, February 2020
Treat yourself to an Ascension retreat in luxury surroundings.
Legal Name: *
First name as you would like it to appear on your name tag *
Address (City & County only) *
Country: *
Nationality: *
Date of Birth: *
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Gender *
Phone: *
E-Mail: *
Please be sure that you enter your email correctly.
Dietary Requirements: Due to allergies, intolerances, or medical needs. (not preferences) *
Please note that all food is vegetarian.
Required
Course Fee
£1,045 GBP all inclusive. Non-refundable deposit of £345 due upon booking. Balance of £700 due no later than 15 January, 2020. *
Or you can pay full amount now.
Contact Details in Case of Emergency:
To best assist you in case of emergency, we ask that you provide us with the following information:
Name of Contact Person: *
Relationship to Contact Person: *
Contact Phone Number: *
Contact Email: *
Contact Details of your Physician:
Doctor's Name *
Doctor's Phone Number(s): *
Your Medical Information:
Blood Type:
(if known)
Please check off all conditions that have occurred in your medical history:
Describe the history of each of these conditions, including dates.
Please be SPECIFIC and detailed, especially about allergies or mental illnesses.
Please tick any of the following that apply to you:
Please list all Prescription Medications you are currently taking:
Name, Dosage, Frequency and Reason for taking them.
Terms and Conditions of Attendance
Satta and Narain Ishaya and the other teachers in association with The Bright Path hereby commit to provide the meditation tuition involved with Ascension Retreats, through the established methodology.

The Bright Path Ishaya programmes are educational experiences and are not to be mistaken for medical or psychological counseling or treatment.

Satta and Narain Ishaya and the other teachers in association with The Bright Path are not responsible for injury or loss arising in connection with programme participation.

Satta and Narain Ishaya and the other teachers in association with The Bright Path are not to be held accountable in cases of theft, violence, conflicts of interest, physical damage or accidents suffered by any participant along his or her stay during the course.

- International medical or health insurance is recommended during the course if you are from abroad.
- Please note that the deposit is non-refundable and non-transferable.
- Please note that once the course has begun no refunds will be issued.
*
Required
Declaration
I, the undersigned hereby state my will to take part in the 10 Day Retreat in Bath, UK from 19-28 February 2020, which will be conducted by Satta and Narain Ishaya.
Participants Declaration: *
Required
SIGNED: *
Please enter Participant's Legal Name as your Signature.
Please enter the date of agreement to the Terms and Conditions and your Declaration. *
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Please press SUBMIT at the bottom of the page to complete your registration.
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