The Middle Way Retreat

Application



Preferred date :
Second Choice:
Name :
DOB :
Gender :
Address :
Contact no :
E-mail :
Emergency contact person and phone number :
Special food requirements :
Special needs requirements :
Are you allergic to anything?
Are you a snoring sleeper?
Do you have any medical condition that we should know about?
Have you mediated before?
Have you attended a retreat before?
What do you hope to gain from this retreat?
How did you hear about The Middle Way Retreat?:
How did you hear about the Dhammakaya International Society of Australia Inc. (DISA)?:
Do you agree to abide by the ethos of the Meditation Centre during your stay?:

 

I acknowledge that i have read and understand the notes about the retreat and the rules laid down concerning the behaviour of participants. Submission of this application from constitutes acknowledgement of my agreement to abide by the rules of the retreat. I realise that if i contravene these rules, am unruly, distracting to other participants or ortherwise detrimental to the retreat, the property or the participants or staff I may be discharged from the retreat at any time.

The application for retreat date after 1 July 2008 will only be completed once we receive full payment. Processing the payment mean you accept the Cancellations or Date Changes Policy.

Cancellations or Date Changes Policy

• Cancellations or Date Changes permitted if requested at least 7 days prior to your retreat date. Charges apply:
1. For date change a fee of AUD$35 is charged per application.
2. For cancellation, a fee of 20% will be deducted from your payment
3. There will be no refund if notice is given after 7 days before the retreat commence.