Registration Form: A Year of Mindfulness

Important: The following questions are purely for the purpose of supporting practice in the program. 
We are asking questions around race, gender etc. because we hold a sincere intention to create greater inclusivity and safety for all participants of the program. And make this program welcoming and supportive for people coming from varied backgrounds.


Name *
Eg: He, She, They, Ze or Other
Section 2: Meditation and Retreat Experience
Section 3: Reflective Questions
(Yes/No) If yes, please describe. Please note that your stating 'yes' will not limit your participation. We wish to do our best to welcome people from diverse abilities and experiences at this retreat. Your answer simply helps us plan better so that we can offer the resources and facilities that will support you.