Have you attended a retreat before?
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Which retreat are you registering for?
Please select from the following...AoM 7day Level 1 Retreat 28th March–4th April 2020
How did you hear about Burgs and the Art of Meditation? If someone recommended us to you, please let us know who it was?
Please mention any previous meditation experience you have had with other teachers or other spiritual interests. Include dates and location where possible.
What is your reason for wanting to attend this retreat?
We have your information already. Please click Next
Do you have any history of physical illness, operations, accidents, or suffer from any long-term degenerative disease? If so please give details with relevant timings.
Please name any medication that you are currently taking, or have taken in relation to this and when.
Do you have any history or diagnosis of emotional/mental health issues such as depression, anxiety, suicidal feelings or attempts, drug or alcohol abuse?If so, please provide some details. Please include information on any therapy you may have received/are currently receiving.
Please name any medication you are currently taking/have taken for this.
Select a Diet from below. Food on retreats will be simple vegetarian food.
Normal VegetarianVegan/Gluten Free
Any specific allergies *required (anything that is life threatening)
Please note that we aren't able to cater for lifestyle food choices. Thank you for your understanding.
Preferred Room Type (Please note that single rooms are limited in availability and are generally prioritised for those with illness or elderly.)
Single Shd BathTwin - Female OnlySingle Shd Bath (Supporter)Single Shd Bath (Assisted)
Other notes (Please add anything you feel would be helpful for us to know about you and you coming on retreat)
I agree that all the information I have provided is correct. I agree to abide by the Art of Meditation code of conduct whilst on retreat, and I take full responsibility for myself, and my actions for the duration thereof.
IMPORTANT: We cannot be held responsible for anything that may happen to you on retreat if you have not provided us with an honest appraisal of your current circumstances.
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