Two Day Chan Retreat - Saturday 13th November - Sunday 14th November 2010
Please fill in this form & return it with your fee of £65. Personal information given will be treated in confidence. Cheques should be made out to "Glastonbury Chan Group". (We will always attempt to re-fill any cancelled place, in which case we will offer a refund).
|
Surname: |
|
First Name: |
|
|
|
Address: |
|
|
|
|
|
|
|
Post Code: |
|
|
|
Telephone: |
|
Mobile: |
|
Email: |
|
Gender: |
|
Date of Birth: |
|
|
|
Previous Retreat experience: |
|
|
|
|
|
|
|
|
|
|
|
Special Diet / Needs: |
|
|
|
|
|
Do you suffer from any physical/mental health problems: |
|
|
|
|
|
|
|
|
|
Do you need or can you offer a lift to the venue: |
|
|
Please note that refunds will only be available if we can reallocate the cancelled booking or if the event is cancelled. Please return completed forms to:
Ned Reiter
Chan Retreat
13 Bere Lane
Glastonbury
SOMERSET BA6 8BD