15 Corfu

Vipassana light retreat October 10-17, 2015. At Agios Georgios Paghi, Corfu. English spoken.

Family name

Cette question est obligatoire.

Name

Cette question est obligatoire.

Gender

Cette question est obligatoire.

Date of birth

ddmmyyyy

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Address: street & number

Cette question est obligatoire.

Address: postal code, city, country

Countries like on licenseplate of cars (e.g. NL, D, I)

Cette question est obligatoire.

Telephone

Preferably cell-phone so that you can be reached during arrival

Cette question est obligatoire.

Email address

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Telephone or contact address

of a friend in case of emergencies

Cette question est obligatoire.

Payment

Will pay deposit now and remainder latest September 10, 2015

Agrees

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Type of room

Twin room 475E or single room 575E (both full pension).

Twin
Single

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Agreement

If you are (or have been) under treatment of a psychiatrist or are taking psychoactive drugs, you are requested to discuss with your doctor and meditation teacher whether participation is fitting at this moment in time. You can reach Henk Barendregt by email <hbarendregt@gmail.com>. Participant declares: "I register for mentioned period of retreat and have the intention to keep the rules of the retreat as much as possible. I know that I cannot keep the supervisor(s) responsible for my personal development. The supervisor(s) will give their best effort to support the participants to develop mindfulness for the sake of their progress."

Agrees

Cette question est obligatoire.

Meditation experience

type of meditation & teacher (no experience required)

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Comments

Optional. It is possible to request a transfer from airport to center for 15E/person

Cette question est obligatoire.