Samadhi Center 2019 Pre-Registration Form
Full Name *
Your answer
Email address *
Your answer
Sex *
Which Samadhi Center retreat do you want to sign up for? *
We do our best to accommodate your preferences. You will be notified if your choice is not available. I would like my accommodations to be in: *
Home Phone *
Your answer
Address *
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City, Province/State *
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Country *
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Emergency Contact: *
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Emergency Contact Phone Number: *
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To secure your place in a retreat we can send you an invoice using Paypal (which can be paid by any credit card- you don't need a Paypal account). Or we can do an Interac money transfer. *
Do you have meditation experience (please describe): *
Your answer
Do you have any health issues that may affect your ability to attend a meditation retreat? *
Your answer
Although meditation is helpful for most people, it is not a substitute for medical or psychiatric treatment and we do not recommend it for people with serious psychiatric disorders. If you are unsure whether a meditation retreat is right for you please contact us at contact@samadhi.ca. If you have any mental illness or are on any mind-affecting drugs please leave any pertinent information in the space below. *
Your answer
Do you have any food restrictions, allergies, or environmental health concerns? If you have a food restriction, please indicate whether it is an allergy which requires no cross-contamination in the kitchen, or whether it is a food intolerance, or a preference. *
Your answer
The bunk beds can safely support persons of up to 250lbs. Is your weight over 250lbs? We will try to accommodate accordingly. We typically only use the lower bunks during retreats, so you will have a whole bunk (top and bottom) to yourself. *
Maintaining silence allows participants to go deep into their inner worlds. Do you have any concerns about being in silence for the duration of the retreat? If yes, please elaborate. *
Your answer
Do you snore? (We try to adjust the dorms accordingly) *
Each day participants contribute "seva" or "selfless service" to the operations of the center. Please select the job(s) for which you are best suited. *
Required
Is there anything else that you feel would be helpful for us to know about yourself? *
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How did you find out about the Samadhi Center? *
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