First Name *
Surname *
Street/Number *
ZIP Code *
Town *
Country *
Phone *
Email address *
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I would like to register for a course/group retreat.
Which course / Which group retreat?
Group retreat from
until
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I would like to register for a single retreat.
Single retreat from
until
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Preferred accommodation * Single room Double room Dormitory
I would like to share a room with… This partner or friend should register separately nevertheless, please!
I am bringing my family along.
Names and age of children, name of 2nd parent if applicable)
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Arriving by… * Car Train
PICK-UP TRAINSTATION OY-MITTELBERG:
Please inform us a day before by phone about your time of arrival. Should your time of arrival change, please let us know as early as possible . Thank you! Phone: +49 (0)8366 – 98380
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Buddhist Center *
Is it your first visit? Yes No
Do you need practice explanations? Yes No
What is your meditation practice? *
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My first meal at the center on day of arrival: * Breakfast Lunch Dinner none
I am a vegetarian
Questions and remarks
I would like to receive the newsletter (program, Bergpost, invitations for events – app. 10 mails per year) Yes No
Please remember to let us know if you cannot come!
__________ In case you experience problems sending the form, please check if you filled in all the required boxes marked with an *. They then should be framed in red. __________
3 + 5 = ? Please prove that you are human by solving the equation *
