Request Form for Accessible Single Rooms

Request Form for Accessible Single Rooms
Name*

First NameLast Name
Email*
example@example.com
Mobile Number*

Area CodePhone Number
Accommodation
In-person Spring Renewal Retreat: Meditation & Movement, April 2026
Single room with private bathroom for health needsAccessible single room with wheelchair access & private bathroomOther
Standard/shared room
Single rooms can be booked at the Early Bird (£1,105) Standard Rate (£1,228) directly via our website, without completing this request form.
My annual income is less than £22,000 (or £25,000 in London)Another reason
Please describe here
Accessible room
Please describe shortly the health condition or disability that requires you to use an accessible room*
Please use the space below to tell us anything further about your requirements
One time paymentPay in instalments
6x monthly payments £83.30 each5x monthly payments £100 each4x monthly payments £125 each3x monthly payments £166.70 each2x monthly payments £250 each
Once we receive this form with instalments request, we will create a payment link and send it to the email address you provided. After your first payment, Stripe, our secure payment platform, will save your card information which will be used for remaining instalments. This payments for instalments will be automatic, and you will be charged on the same day each month. You will receive a payment confirmation after each transaction.

By submitting this form, you agree to set up automatic payments. Please note that manual payments are not an option.
Standard rate = £1,228Concessionary rate = £983
Standard rate = £675Concessionary rate = £575
DO NOT USE Which rate can you afford to pay?*
DO NOT USE Which rate can you afford to pay?*
Once you submit this form, a link to the Payment Plan form will appear. Please complete the form, and we will get back to you as soon as possible
Thank you!
Should be Empty:

Request Form for Accessible Single Rooms

Accommodation

Standard/shared room

Accessible room

Thank you!