Home coming Retreat Registration May 17-19 2024

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Email *

Name *

D.O.B

YYYY

Occupation

Mobile *

Where do you live ? (city or town) *

Emergency Contact Person and Mobile Number *

Any current health problems? *

Are you taking any Medication/Herbs/Supplements? *

Any past health conditions or surgery? *

Anything other information you think is important for organizers to know?

Which Yuan gong methods have you learnt ? *

Tian Yuan (gathering qi)

Di Yuan (standing form storing qi)

Ren Yuan (stretching qi)

Xia Yuan (organ healing method)

Zhong Yuan (Microcosmic circuit)

Tong Yuan (heart opening and healing meditations)

Ling Yuan (meditations to work on the patterns)

Ming Yuan (awareness in everyday life)

I am new to Yuan gong

Required

Any other modalities you have tried and/or are currently practicing?

Thinking about your current life and what you would like to get from the retreat are there any topics in particular that you would find beneficial to have as a focus during this retreat *

Accommodation *

Please understand accommodation is limited and we will do our best to accommodate your wishes.

Single $420 (3 places)

Twin $380 ( 4 places 2 in yurt and 2 in house)

Camping $340 (2 places for tent and another campervan space)

0ffsite $300

Option 5

Lunch, Dinner and an afternoon snack will be provided

Please bring something simple for breakfast.

please indicate any dietary requirements so the caterer is able to put together the best possible menu for you

Vegan

Vegetarian

Dairy free

Gluten free

Grain Free

Other

No Requirements

Please pay into 123494005895000 Account name: NJ Meijer (REF: your name/ Code:March 2024 retreat) (see refund policy below***) *

I have paid $100 deposit

I have paid in full

l would like to discuss payment options with you

Other:

Thank you for your registration, All information provided on registration form remains confidential. All information is used to increase the effectiveness and safety of the teachers retreat facilitation and teaching.

I am looking forward to offer this nourishing and uplifting weekend : ) If you have any questions at all please email Natalie natalie@heartwisdom.co.nz

**** REFUND POLICY***
Fully refundable if you cancel 30 days before event
50% refundable if you cancel up to 7 days before event
No refund one week before event
NB If we can fill the space you will receive a full refund minus 15% admin fees

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