Registration Form
Qi & Mindfulness Summer Retreat 2023
11th - 14th August 2023
Please enter your details below, then click 'Continue' to go to the Confirmation page. Entry titles marked with an asterisk * are required.
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Your Details
First Name *
Last Name *
Email *
Phone *
Address 1 *
Address 2
Post Code *
(if in England, please leave blank)
T-shirt size - free for all participants *
Registration Details
Residential / Non Residential - Full Retreat Options (Fri - Mon)
Residential/Non Residential
Tick box if you are taking & sharing a room with a partner who is not taking part in any training - £330 extra
Name of person to Twin sharing with (if Known)
Note: Unless you specify a person to share, we will arrange someone to share with you.
If that is not possible then single room fee will apply!
Dietary Requirements
food Allergy
Day Delegate Options
Day Delegates (NO meals incl.) - Tick the Day/s you would like to partake
DON'T choose day delegate below if you sign up for Full Retreat
Friday Afternoon - Yi Jin Jing & Tui Na
Day Delegate - Day Options (Sat - Mon)
Forms to be revalidated (Deyin Forms only)
Please list the names of forms in box above for revalidation and we will get back to you with detail and costs of reval fees.
Payment Options
Discounts - Repeat particpant or EC member only
Payment Method *
Bank Transfer Details
Bank: TSB
Name: Deyin Event Management Ltd
Sort Code: 772710
Acc. No: 00062005
IBAN: GB84TSBS77271000062005
Please read the conditions on the
Event Participant Disclaimer
I accept all conditions on the Event Participant Disclaimer *
Billing Total £
Payment Total £
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