Application Form: Dreams & Tracking Retreats 2025

Dreams & Tracking Retreat Dates 2025*

Retreat 1: February 16th - 24thRetreat 2: March 2nd - 10th

Okavango Delta Safari extension*

After Retreat 1 finishing on February 27thAfter Retreat 2 finishing on March 13thNot doing the extension

Full Name*

First NameLast Name

Date of Birth*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email Address*

example@example.com

Your Mobile Number (including country code)*

Who to contact in an Emergency

Emergency Contact Name*

Emergency Contact Number*

Relationship to you*

Intention for coming on this retreat? (Please write a few lines)*

Do you have a Spiritual practice? (Include a brief history of your background & experience)*

Do you have a history of mental or physical illness? (Such as bipolar, schizophrenia, major depression etc. Please give a brief outline)*

What is your current physical and mental state? Please be aware that deep spiritual work can bring up difficult emotions and old wounds. *

Are you able to walk 5km (3miles) in one hour without physical stress?*

Do you suffer from any allergies?

Do you have any dietary requirements? We will be in a very remote area with specialized foods hard, but not impossible to source in Botswana. NB Please be aware there is a surcharge of $150 USD*

Dietary requirements*

Yes ($150 USD surcharge)No

Price of retreat includes accommodations in a shared 2-person room. There is an additional charge for a single room supplement.*

Shared roomSingle room (Additional USD surcharge - speak to Bev - booking agent)

Where did you hear about Dreams & Tracking Retreats?*

It is a requirement of this retreat that all participants take out comprehensive travel insurance. We require a copy of your medical insurance.*

I agree to having comprehensive travel insurance and will provide a copy of my medical insurance

Nature is unpredictable and the Kalahari, although extremely beautiful, is also dangerous. It is vital that all participants adhere to the Health & Safety instructions laid out by Alwyn Myburgh when they arrive.

*If any participant puts themselves or any member of the retreat at risk then they will be asked to leave at their own expense with no refund.

NB: No part of this retreat can be shared, copied or distributed. John Lockley and Alwyn Myburgh hold the sole copyright of their respective teaching modules.

I, First Name* Last Name* have read and agreed to all clauses stated in this form. I indemnify John Lockley, Alwyn Myburgh and Associates from any harm, loss of property or personal injury that may result from me participating on this retreat.
Date

Signature*

Application Form: Dreams & Tracking Retreat 2025