Samadhi Center 2022-2023 IAM 9 Day Retreat Pre-Registration Form
These retreats are on a first come first served basis. We will be arranging a zoom call with each participant to make sure it is a good fit. 
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Email *
Which date would you like to sign up for? *
Full Name *
Home Phone *
Address *
City, Province/State *
Country *
Email address *
Age *
Emergency Contact: *
Emergency Contact Phone Number: *
Sex *
Why do you want to attend the IAM retreat? What are you looking for? *
Do you have any health issues that may affect your ability to attend a meditation retreat? *
Are you on any medications or supplements? *
Are you able to taper off of all medications, supplements, drugs, alcohol, with the help of your doctor? *
Although meditation/ self inquiry is helpful for most people, it can bring up previous trauma from the past and is not a substitute for medical or psychiatric treatment. We do not recommend it for people with serious psychiatric disorders or those who have suffered severe trauma that has not or is not being addressed. If you are unsure whether a meditation retreat is right for you please contact us at contact@samadhi.ca. If you have experienced or have a history of trauma, depression, anxiety, loss (either a significant death, job, home, income...) or are on any mind-affecting drugs, please leave any pertinent information in the space below.
 *
Do you have any food restrictions, allergies, or environmental health concerns? If you have a food restriction, please indicate whether it is an allergy which requires no cross-contamination in the kitchen, or whether it is a food intolerance, or a preference. *
We do our best to accommodate your preferences, however cabins and private rooms are assigned on a first come first served basis. *
Do you have meditation experience (please describe): *
Is there anything else that you feel would be helpful for us to know about yourself? *
Do you snore? (We try to adjust the dorms accordingly) *
Maintaining silence allows participants to go deep into their inner worlds. Do you have any concerns about being in silence for the duration of the retreat? If yes, please elaborate. *
The bunk beds can safely support persons of up to 250lbs. Is your weight over 250lbs? We will try to accommodate accordingly. We typically only use the lower bunks during retreats, so you will have a whole bunk (top and bottom) to yourself. *
To secure your place in the retreat we can send you an invoice using Paypal (which can be paid by any credit card- you don't need a Paypal account). Or we can do an Interac money transfer. We will refund your payment if you cannot attend the retreat for some reason. *
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