Samadhi Center Personal Retreats Registration Form
It is important for us to insure that our meditation retreat environment will serve you well. To that aim, please answer each of the questions below.
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Email *
Full name *
Please select your arrival and departure dates within the date blocks below. We require a two night minimum with a maximum of nine nights (10 days). You do not need to book the full date block.
• Jan 15th to the 24th, 2023
• April 16th to April 25th, 2023
• June 18th to June 27th, 2023



Requested arrival Date: *
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Requested departure date *
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Sex *
Accommodation are assigned on a first come first served basis, and according to medical needs. We do our best to accommodate your preferences but there are no guarantees. Personal retreat price is $120.00 per night, meals included.  Please select your preferred accommodation below.  *
Home phone *
Full Address Including Street Address, City and Province or State/ Country: *
Emergency Contact Name: *
Emergency Contact Phone Number: *
We usually send a Paypal or Interac. Which payment method do you prefer? *
Do you have daily meditation practice? (please describe): *
Please describe in detail what you hope to gain from your time at the Samadhi Center. *
Have you done meditation retreats before? If so please describe in detail. *
Do you have any health issues that may affect any aspect of your stay at the Center? *
Do you have any dietary restrictions or food allergies? Please include intolerances and allergies, not preferences. *
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. *
The bunk beds can safely support persons of up to 200lbs. Is your weight over 200lbs? We will try to accommodate accordingly. *
Do you have any serious allergies, or environmental health concerns? *
Do you have any concerns about being in silence and/or isolation for the duration of the retreat? (Please elaborate if the answer is yes). *
Do you snore? (We try to adjust the dorms accordingly) *
Which classes and services are you interested in while you are at the Samadhi Center? Please check any that apply. *
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