Application for A Lotus Seed Retreat
Thank you for joining A Lotus Seed Retreat! To apply to the retreat, please fill in these questions and state your motivation. The answers will be kept strictly confidential and will be solely used for the purpose of ensuring to you the best experience possible. We take privacy seriously - You can consult our privacy policy here: http://www.alotusseed.org?open=privacy-policy

Because it is a retreat that also has an impact on mind, body and brain, it is important for us and for you to be aware of your physical and mental health. We therefore also ask questions about your health.

By sending this application, you acknowledge that everything you wrote is true and are not witholding any information.

If you have any questions, you can contact me at info@alotusseed.org or whatsapp: +32478135069

A lotus for you,
Geraldine

Which retreat would you like to join? *
Name
Your answer
First name
Your answer
E-mail
Your answer
Birth date
Your answer
Street and number
Your answer
Postcode
Your answer
City
Your answer
Cell phone number *
Your answer
Country
Your answer
What's your motivation or main reason for joining the retreat?
Your answer
Have you already meditated or followed a mindfulness training before?
If yes, please specify.
Your answer
Do you have any physical or psychological challenges?
If yes, please specify what, how long and the current status.
Your answer
Do you take any medication?
If yes, please specify daily/weekly amount.
Your answer
Are you followed by a health physician or following any alternative treatment?
(doctor, psychologe, psychiater, psychotherapist, ... )
Your answer
From where are you traveling to Portugal/France and how?
If you need help booking your flight, please indicate.
Your answer
What type of room would you like? See all practical info and prices on www.alotusseed.com/#practicals
Do you need an invoice?
If yes, what is your VAT number, name of company and address?
Your answer
How did you hear about this retreat?
Any suggestions, questions or special requests?
Your answer
Do you agree to the informed consent? Please read it here: www.alotusseed.org/informed-consent-retreat
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