Coming Home to Stillness Retreat

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Personal and health information questionnaire

Name *

Date of birth *

YYYY

Mobile number *

Email *

Address *

Current injuries, illnesses, mental health or medical conditions including any currently managed by medication *

Allergies, food and/or others *

Dietary Requirements *

Experience with yoga and/or meditation. Please indicate duration and style of practice *

Reason for retreat. What do you hope to get out of participation *

Additional requests or requirements

Room Selection *

Twin share Rainforest Hut - Early bird price $1520 (before 31st Jan 2021)

Twin share Rainforest Hut - Full price $1720

Single Rainforest Hut - Early bird price $1750 (before 31st Jan 2021)

Single Rainforest Hut - Full price $1950

(Sold Out) Twin share Deluxe Cabin - Early bird price $1720

(Sold Out) Twin share Deluxe cabin - Full price $1920

(Sold Out) Single Deluxe Cabin - Early bird price $2150

(Sold Out) Single Deluxe Cabin - Full price $2350

Terms and Conditions

Financial:
A non refundable deposit of $500 is required to secure your booking.
The remainder of the fee must be paid before the 31st of May.
Cancellations must be given in writing prior to the 31st of May, otherwise all fees will be forfeited.
Cancellations made before the 31st of May will be eligible for full payment refund less deposit amount.
The retreat requires a minimum number to run. Should this minimum not be reached, the retreat will be cancelled and all payment, including the deposit, will be fully refunded.
Home of Equanimity reserves the right to cancel the retreat where all payment, including the deposit, will be fully refunded.

Pre-Retreat requirements:
All bookings must be made with a health and personal questionnaire filled out.
Participants are responsible for their own wellbeing and assert upon booking that they are medically fit for general exercise and will take caution not to strain or injure themselves while participating in the retreat.

During retreat:
The retreat will be drug and alcohol free.
Photos taken may be used for promotional purposes.
Twin share option is only available for joint bookings and not individual ones.

Agreement *

I have read and understand the above terms and conditions of booking

Required

Payment

Please make payment either in person or via Bank Transfer to the following account:

Name: Han Wee Tan
BSB: 013600
ACC: 189224197

Thank you for booking into the retreat! A confirmation email will be sent out to you. Please keep an eye out for it in your junk folder.

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