5 Day Silent Retreat NY Application
Please complete this application in order to participate in the silent meditation retreat in Woodstock, NY. Responses will be kept confidential and are used to better support you on retreat.
Email address *
Name *
Your answer
Age *
Your answer
Occupation *
Your answer
Gender and preferred pronouns *
Your answer
Room choice (room held upon payment). Please make sure your room choice is still available on (https://jwhitneyyoga.com/5dayretreat/) *
Where and and with whom have you studied yoga and/or Buddhism and for how long? *
Your answer
What is your practice? (ie. daily sitting, yoga asana, etc.) *
Your answer
What are some of the challenges you might encounter in the retreat? *
Your answer
Have you been on a silent meditation retreat before? *
If yes, with whom/in what tradition?
Your answer
Why are you interested in participating in this retreat? *
Your answer
Do you have any food allergies or dietary restrictions beyond vegetarian? If yes, specify. *
Your answer
Are there any medical, physical, or psychological conditions that you feel are important for us to know about to better understand your needs regarding this retreat? If yes, please explain. *
Your answer
Emergency contact (Name, relationship, phone number) *
Your answer
Meditation Retreats can at times be psychologically and emotionally stressful. In the event of a psychological emergency, do you have a therapist or psychiatrist that we could contact? If yes, please give name and phone number. *
Your answer
Any final comments?
Your answer
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