Open Way Zen Sesshin Application Form

Your Contact Details:
Full name:
Street address:
Home phone:
Mobile phone:

Please Specify:
Special dietary requirements:
Previous mediation experience / retreats:
Any medical or psychiatric conditons:

In An Emergency Please Contact:
Home phone:
Work phone:
Mobile phone:

I need a lift to the retreat:
From (place):
On (date):
At (time):
I can offer a lift to the retreat:
From (place):
On (date):
At (time):
I can help transport gear to the rereat:

Zafus and Zabutons (Cushions and Mats):
I will bring my own zafu or stool:
I need a zafu:
I will bring my own zabuton:
Please specify any special seating requirements:

Medical or First Aid Qualifications:
I have a current medical qualification:
I have a current first aid qualification:
Please provide details:

Please note that there will be only limited scope for us to deal with special dietary needs.
The standard menu will be lacto-ovo vegetarian, i.e. vegan plus egg and milk-based foods.

By clicking Submit Application Form - I:

An indemnity form will need to be signed upon arrival at the retreat centre - contact us if you have any questions regarding this.

Please check all information is correct before clicking the button below