Day Retreat Registration Form

Silent Mindfulness Day retreat registration form

With Adele Stewart
Please make full non refundable payment on registration. It is necessary to have some meditation experience and have attended at least one silent day retreat. You will need to be able to care for your own emotional and physical needs on this retreat. Retreats start at 9.45 for 10 and end 4 then clean up. An email will be sent out the week before with further details.
Name*

Preferred First NameLast Name
E-mail*
example@example.com
Mobile Number*
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Retreat date and venue
Any questions or comments. If Adele doesn’t know you please put down your meditation or retreat experience.

Payment. Tick Day retreat box and choose rate. If using mobile phone, you may need to click over text rather than box.

Day retreat Early BirdIF YOU HAVE ATTENDED ANY RETREAT PREVIOUSLY WITH ADELE THE EARLY BIRD FEE IS $40. Otherwise the early bird fee is $50 or $45 for Insight Timer registrants. Please pay supporting rate if you can afford to support another and supported rate if you need to; this includes Insight Timer registrations.

$40.00AUD

Total

$0.00AUD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

Silent Mindfulness Day retreat registration form