Registration form Yamantaka practice and study retreat 2019

Contribution to the costs of full retreat Saturday 28 December 2019 to Friday 3 January 2020

€100 (Members)
€120 (Non-members)
€70 (Low income/students)
Not applicable: I do the three-day retreat

Please tick the appropriate box.

Contribution to the cost of three-day retreat Saturday 28 Dec. to Monday 30 December 2019

€60 (Members)
€80 (Non-members)
€40 (Low income/students)
Not applicable: I do the complete retreat

Please tick the appropriate box.

I want mediation in finding a place to sleep

Please tick the appropriate box.

Contribution to the costs of catering

€5 per breakfast
€12,50 per hot meal (in the afternoon)
€7,50 per cold meal (bread, in the evening)
No catering required

Please tick the appropriate box.

Solidarity Fund

Jewel Heart has a solidarity fund for people who would like to attend activities but cannot fully afford to do so. If you want to apply for a contribution from the solidarity fund, please contact the secretariat in advance (info@jewelheart.nl). If you want to contribute to this solidarity fund, you can indicate above for what amount.

Total contribution to the costs

The total amount (to be added up yourself) will be transferred to IBAN NL95 INGB 0005 7122 89 Jewel Heart Nijmegen, quoting Yamantaka retreat 2019.

My name

My e-mail

I'm a member of Jewel Heart

I like to sit on a

Cushion
Chair

I want to help prepare for Friday, December 27.

The participants are expected to jointly ensure that the retreat runs smoothly, including all common domestic work during and after the retreat.

Adress

Entering your name is obliged.

Postal code

City

Telephone

Remarks

Do you have any comments? You can put these above. We will try to respond as soon as possible.

Yamantaka practice and study retreat from Saturday 28 to Monday 30 December 2019 or until Friday 3 Jan. 2020