Please complete this registration form if you would like to attend the next retreat or group therapy session.

We realise the personal nature of these questions. Please be assured that the completed forms are seen only by the teacher and kept in strict confidence.

This is a generalised form for all of our groups and retreats. Please only answer questions you feel are relevant to yourself and the group/retreat you are registering for.

Contact details:

Personal information:

Below are a few questions we'd like you to answer. These are designed for us to let me know a little about you before we meet. This information is confidential and will only be viewed by the facilitator.

General Information:

Please enter the two words that appear below: (required)

Any information you submit is held in the strictest of confidence. You can be assured that your email address will never be sold to an outside company. For more information, view our Privacy Policy.