Registration Form
Parenting Ourselves Retreat

This is the registration form for the English Spoken International Retreat.
Please use this link to register for retreats given in Dutch.

Teachers

Susan Bögels & 
George Langenberg

Address

This is the address of the retreat:
De Hoorneboeg
Hoorneboeg 5
1213 RE Hilversum

All information about this international retreat

Price

  • 1425, for a shared room 
  • 1875, for a single room

Register

You can register for the retreat using the form below.
In addition to your name and address details, we ask you to complete all other fields as well.

    I am registering for this retreat:

    First and last name:

    Your Occupation:

    Gender:
    MaleFemaleOther

    Street and house number:

    Postcode:

    Town / city:

    Country:

    Email address:

    Telephone number:

    Room preference:
    Single room 1875 euroDouble room 1425 euro

    Motivation:

    Please briefly describe your motivation for joining this silent midweek retreat and share something about your meditation practice.

    Have you attended a silent retreat before?
    YesNo

    If yes, what type of retreat and how long was it?

    Have you taken part in a mindfulness training before?
    YesNo

    If yes, with whom and when:

    Have you completed a mindfulness teacher training?
    YesNo

    If yes, where and when?

    Physical and mental health:

    Please share any current or recent physical or mental health issues that may affect your participation, or any other information that may help us support you.

    Emergency contact:

    Please provide a name, telephone number and your relationship to this person.

    Additional comments:

    GDPR:
    I agree to the privacy policy/ terms and conditions.

    After submitting, you will see a confirmation on the next screen. Your registration is only complete once this confirmation appears.