Registration for the weekend retreat 14-16/6
The following information is strictly for the confidential use of the retreat teachers, Zohar Lavie, Nathan Glyde and Susie Jones. Please answer these questions fully to enable them to guide you appropriately.
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Name *
Email address *
How did you hear about this retreat? *
Have you been on a retreat before (weekend or longer)? Please give details *
At the retreat centre there are a small number of single rooms, most rooms are doubles and triples, one quadruple (all have single beds). Priority will be given to those who might need a single room for health reasons. Although we cannot guarantee which room you will get please indicate here your needs and preferences  Please note the registration fee for single occupancy is 220 euros, shared room is 180 euros.
If you are coming with somebody and would like to share a room please give their name here
The meals are healthy, vegetarian and cooked on-site. Do you have any specific dietary requirements or allergies?
We would like to organise car-sharing to and from the retreat centre in Dongelberg. Please indicate if you are potentially interested in this either as a driver or as one needing a ride.
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Do you have any history of physical illness or any disabilities, which may significantly affect your sitting, standing, or walking practice?
Have you ever been diagnosed with or experienced any significant mental health issues, e.g. depression, eating disorders, anxiety, trauma, addictions, drug/alcohol abuse? If yes, please give details of condition(s) and date(s). Please mention any medications currently being taken.
Describe any present circumstances that might place you under additional stress or may significantly affect your practice (e.g. loss, bereavement, relationship breakdown, etc.)
To support ourselves and each other during the retreat there will be periods of silence, and a request not to use electronic devices such as mobile phones during the weekend (unless there is an emergency).
Do you agree?
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The registration fee of 180 euros per person (sharing a room) and 220 euros (single room) covers the basic costs of renting the retreat centre for the weekend (room and all meals included) & travel costs of the teachers.
It does not include the costs relating to the teaching of the retreat, so you are asked to make a financial contribution to Zohar and Nathan for the teachings and guidance offered during the retreat.
Do you agree?

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Health safety: we request that participants who may have any flu/Covid symptoms prior to the retreat stay at home.
Do you agree?
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Cancellation policy:
Before 31 March full refund minus 20 euros admin fee
Between 01/4 and 31/5 refund of 50 euros
After 1 June there is no refund
Do you agree?
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Disclaimer: Do you agree to take full responsibility of your physical and mental health during the retreat? *
Is there any additional information you would like to convey to the teachers or any question ?
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