padmaloka buddhist retreat centre

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Retreat Booking Form (printer friendly)
To book on a retreat at Padmloka please fill out this form, print it out and send it to us together with your payment.

Select Retreat:
Name:
Email:
Telephone Number:
Address:
New To Padmaloka:  If you are new to Padmaloka, please let us know how much experience you have with meditation and/or the FWBO. Please provide details below:
Special Dietary Requirements  (for medical reasons only). Please provide details below:
Health: For welfare and safety reasons please let us know if you have any disabilities or serious health problems such as diabetes or epilepsy. We also need to know if you suffer from any mental health problems - particularly if you are on medication. Please provide details below:
Additional Info: (accomodation, snorer, disabled access etc). Please provide details below:
Tick here to request concession rate. How did you hear about us?
Payment
Deposit: (non-refundable / non-transferable) £30 for weekends and £50 for longer retreats
Bursary Donation: I also wish to donate to the Bursary Fund to help people in financial difficulty attend retreats.
If you are a uk tax payer please also consider completing a gift aid form and sending this with your cheque.
Total Payment Cheques made payable to FWBO Surlingham

Now print this form and send to: The Retreat Organiser, Padmaloka, Lesingham House, Surlingham, Norwich, NR14 7AL, UK