Retreat Application

Creative Writing Retreats in UK, Mexico and Costa Rica
On this form, you can secure your spot with a deposit, on the retreat(s) of your choice. Your deposit covers the ‘writing retreat’ activities and is the only fee paid directly to us. Accommodation fees are payable directly to the lodge or hotel.
I would like to reserve space(s) on the following retreats (Check all that you wish to attend)

Mexico Writing Retreat, Saturday 29 November – Saturday 6th December 2025Costa Rica Writing Retreat, Saturday 24th January - Saturday 31st January 2026Costa Rica Writing Retreat, Saturday 31st January - Saturday 7th February 2026York Writing Retreat, UK. Sunday 13 September - Saturday 19 September 2026
Both our Mexico retreat and our second week in Costa Rica require the selection of a specific room type. Please check the information flyer for options and e-mail your room preference to julie@centauriarts.com. If your attendance on the retreat relies upon the availability of a specific accommodation type, please check your preference is available before completing this form.
Primary Traveler/Room Occupant:
Name*

First NameLast Name
Date of birth*

MonthDayYear
Gender*

MALEFEMALE
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Cell Phone*

Area CodePhone Number
Home Phone

Area CodePhone Number
E-mail*
I am the sole occupant of the room *

YESNO, I AM ATTENDING WITH OTHER PEOPLE
Where Did you hear about Centauri Arts Retreat?
Accessibility Needs/ Special Requests
Medical Conditions of which we should be aware
Please list any life threatening allergies
Emergency Contact*

First NameLast Name
In the unlikely event that you should become ill during the retreat, this is the person we will contact on your behalf.
Phone Number of Emergency Contact*

Area CodePhone Number
Relationship to you*
WRITING WORKSHOPS
Please tell us a little about your writing interests and experience

Accompanying Traveller 1 staying in the same room:
Name

First NameLast Name
Relationship to primary traveller
Date of birth

MonthDayYear
Gender
Accessibility Needs/ Special Requests
Medical Conditions of which we should be aware
Please list any life threatening allergies
Is this person taking the Creative Writing Workshops?

YESNO
Please tell us a little about your their writing interests and experience

End
A deposit is required per room to secure space. This deposit is payable in Canadian dollars and covers the portion of the tour supplied by Centauri Arts: Creative Writing Workshops and related activities/materials, plus group leader services. The deposit fees due are as follows:

Mexico Retreat 2025:          $699 CDN per writer, per retreat week.
                                       $150 CDN for accompanying family/friends sharing a room

Costa Rica Retreat 2026      $799 CDN per writer, per retreat week.
                                         $150 CDN for accompanying family/friend sharing a room

UK Retreat 2026                 $750 CDN per writer, per retreat week.
                                         $150 CDN for accompanying family/friend sharing a room

Please specify below how you would like to pay. Once we have confirmed availability of your room, we will call or email you to finalise payment.
I wish to pay by

Interac (Canadian Customers only)Credit card
I have read, understand and agree to the booking conditions in the retreat handout.*

YES
ELECTRONIC SIGNATURE: By entering my name in the space below, I certify the information provided is true and correct, and legally obligate myself to the same extent as I would by signing my name on a printed version of this form
Full Name of Person completing this form.

First NameLast Name
Date

MonthDayYear
Should be Empty:

Creative Writing Retreats in UK, Mexico and Costa Rica