Wilton Long Weekend Retreat Registration Form

Wilton Silent Mindfulness Long Weekend Retreat Registration form

5-8 June 2026 With Adele Stewart and Jenny Steadman
Cancellation policy. Minimum $110 non-refundable deposit to be paid on registration.

Cancellations received up to or before 1 month before the event – the fee will be refunded less $110.
Cancellations received up to 10 working days before the event – 50% of the fee will be refunded.
Cancellations received 10 working days or less before the event – no refund will be made.
However, if a substitute person can be found so that Adele is not impacted financially there will be a 50% refund.

Please note that cancellation policy applies to absence due to illness including Covid.

It is recommended you have attended MBSR 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 (although of course you can reach out to Adele or Jenny if necessary)

It is important to intend to be at the retreat for the entire time. This makes a difference to others experience also.
Name*

Preferred First NameLast Name
E-mail*
example@example.com
Mobile Number*
Details you would like Adele to know to help with your retreat experience:
Dietary requirements (vegetarian)

VeganLactose freeGluten free
Any other questions or comments:

Payment. If using mobile phone, you may need to check over text rather than box.Standard price $750, Supported $650, Supporting $850. Tick Long weekend retreat box and choose rate. *

Long weekend retreat 3 nights single room with ensuite, all meals. Please pay supporting rate if you can afford to support another and supported rate if you need to

$750.00AUD Rate

Long weekend retreat 3 nights share room with ensuite, all meals. Please pay supporting rate if you can afford to support another and supported rate if you need to

$650.00AUD Rate

Long weekend retreat 3 nights single or share room with ensuite, all meals. Deposit. Please complete the two sections below. Final payment to be made by EFT - bank details will be in your confirmation email - or PayPal via Adele’s website by Easter 2026.

$110.00AUD

Total

$0.00AUD

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

Please tick relevant box if deposit only paid:

Single room, lend a hand $740 owingSingle room, standard $640 owingSingle room, need a hand $540 owingShare room, lend a hand $640 owingShare room, standard $540 owingShare room, need a hand $440 owing
Please read and tick both conditions if deposit only paid:

I agree to pay the outstanding amount by Easter 2026 without reminderI am aware that if the outstanding amount is not paid by Easter 2006, I may lose my deposit and place on the retreat.
Should be Empty:

Wilton Silent Mindfulness Long Weekend Retreat Registration form