Community of Mindfulness in Israel Spring Retreat with Dharma Teacher Chan Hao
When: 22-26/04/2020
Where: Neve Shalom Wahat Al Salam - Guest House Neve Shalom
Contact us at: retreats.mindfulness.israel@gmail.com
Please fill out for each participant:
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Telephone Number *
Your answer
Year of Birth
Your answer
Gender *
Your answer
Need translation during the retreat?
Do you have previous experience? *
Note: These questions are for organizational purposes. Previous experience is not necessary
Required
Rooms & Prices *
Payment is to cover expenses. You will be able to show your gratitude to the teacher by offering a contribution according to the generosity of your heart (Dana). Prices include 3 vegetarian / vegan meals a day. Bed linen and towels are provided. We wish to allow participation for people who cannot afford paying full price, for discount application please write to retreats.mindfulness.israel@gmail.com
Invitation to support our scholarships fund
We try to allow participation for those who cannot afford paying full price. We will appreciate other participants contribution:
Payment (Please wait for an email confirming we've received your form before proceeding with payment): *
Payment options In order to confirm your participation, please submit the payment by bank transfer or by BIT. bank account details: "להיות ביחד כאחד", Bank Leumi branch no. 903, Account no. 1633785. Please send a copy of the payment notification to retreats.mindfulness.israel@gmail.com *
I would like to share a room with:
Your answer
Dietary, Medical and special requests
Meals are vegan / vegetarian
Your answer
Emergency Contact name and phone number *
Your answer
comments
Your answer
Disclaimer of Responsibility and cancellation policy: *
I, the undersigned, hereafter referred to as the participant, acknowledge that the retreat organizers are not in any way responsible for the health of participant, theft, damage or harm that might occur to the participant during the retreat, at the venue, or on the way there or back. In case of cancellation, payment will be refunded after a deduction, as follows: until 21/03/2020 - full refund, from 22/03/2020 until 15/04/2020 - 50% refund.
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy