Embodied Psychotherapy Retreats

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- online booking for the residential retreat in Aegina, Greece

Email *

CONFIDENTIALITY

All the information given in this form is fully confidential and would be treated with respect. It will be read only by the IEP facilitators who are abiding to UKCP code of ethics. The information that you share here will not be used for any other purpose than for this retreat.

DATA PROTECTION

Any electronic communication will be with your consent and you can withdraw your consent at any time. If we experience any data breaches we will inform you as soon as possible.

Any records about you (such as personal details on our booking forms) are kept secure and subject to the general data protection regulations. We will keep those record for the duration of your involvement with IEP - up to 5 years. You are entitled to have your data destroyed at any point.

Name *

Date of Birth *

YYYY

Your Occupation: *

Full Address: *

Your Phone Number (in case we need to contact you before or during the retreat): *

Start date of the retreat: *

YYYY

How did you hear about this retreat? *

Payment

To secure your booking please make a payment by bank transfer on the same day of submitting the booking form (you will receive a conformation email after submitting this form):

UK PAYMENTS:

The Institute of Embodied Psychotherapy
Account No: 30354597
Sort code: 23-14-70

GREECE & EU PAYMENTS:

The Institute of Embodied Psychotherapy

BIC TRWIBEB1XXX

IBAN BE38 9677 3722 0372

CANCELATION POLICY: up to 6 weeks before the retreat - your payment will be refunded minus 20% administration fee. No refund will be offered if less than 6 weeks notice.

Concessions: If you are from a low income household and require a concession rate, please get in touch before booking.

PLEASE NOTE THAT THE FEES ARE FOR THE WORKSHOP PART OF THE RETREAT ONLY

FOR ACCOMMODATION AND FOOD - THERE IS 270€ ADDITIONAL CHARGE (payable to the venue on the day of arrival - if possible in cash).

This includes half-board (breakfast and lunch for the whole duration of the retreat, plus 2 community dinners). The accommodation is in shared spacious twin rooms. If you would like a single occupancy - you can arrange it directly with the venue for the additional cost. After we confirm your place please email the venue to book your room: aigina.oikia@gmail.com

Please indicate what rate you are paying? *

UK participants - Early Bird: £365 (up to 2 months before)

UK participants - Full fee: £395 (after 7th September 2024)

Greece & EU participants - Early Bird: €365 (up to 2 months before)

Greece & EU participants - - Full fee: €395 (after 7th September 2024)

Other:

Prerequisites for joining and Safety assessment

This retreat is specifically designed for psychotherapists, counsellors and psychologists who have done at least one of our Embodied Psychotherapy training weekends, workshops or experiential groups in the past and would like to go deeper with their own embodiment.

Given the therapeutic aspect of this retreat we need some personal information about each participant who will join. The following questionnaire is for the facilitators to assess the needs of each participant joining, and also to assess if the group work that we'll do is suitable for the individual (i.e. in the cases of complex PTSD and mental health issues this retreat might not be suitable).

What are you hoping to gain from doing this retreat? *

Please name any previous CPDs trainings or workshops by the Institute of Embodied Psychotherapy that you attended in the past (and what year), or any other personal development groups or workshops run by Katarina or Tasha: *

Previous experience of personal therapeutic work (individual/group psychotherapy, process oriented groups or any other significant personal development workshops): *

What is your previous personal experience of body oriented psychotherapy? *

Any previous experience of dance/movement practice? if so please name a few? *

Any previous experience of meditation or other spiritual practices? (If so - please name what practice had most impact on you, including previous retreats) *

Given the physical aspects of this experiential workshop/retreat are there any medical or mobility issues that we need to be aware of? *

Given the emotional aspects of this therapeutic retreat, are there any mental health issues or emotional problems? (Including history of depression, anxiety or mood disorders, trauma or PTSD, addictions etc.) *

Have you ever suffered from any serious or recurrent illnesses, or had a major surgery or accident/trauma? *

Are you taking any medication at the moment? Any medical issues that we need to be aware of? *

In case of emergencies – who should we contact (name, relationship and their contact number) *

• Would you like to be added to our mailing list for information about IEP's similar events, workshops and courses (including discounts that we offer) *

Yes

• By sending this form I agree with the Institute of Embodied Psychotherapy Terms and Conditions (PLEASE READ THEM BEFORE SIGNING THIS FORM): https://www.embodiedpsychotherapy.org.uk/terms-and-conditions *

Yes

A copy of your responses will be emailed to the address you provided.

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