Retreat Application

Retreatants should plan to return home each night. However, if you wish to stay overnight please contact us for details.

FIRST TIME APPLICANT INFORMATION



PRACTICE HISTORY

The purpose of collecting this information is for the retreat teacher to help guide your practice. Please include as much information as possible below.











TRAVELER INFORMATION

MEDICAL CONDITIONS/FOOD ALLERGIES

You must complete this portion of the retreat application even if you have informed us of medical issues before please include the information again. We request the following information to help us determine whether or not participation in a retreat will aggravate a serious medical condition, endanger a participant's health, or disrupt the functioning of a retreat. The information provided will be kept strictly confidential to protect the applicant's privacy.

Please include:
-Food Allergies
-Serious back or leg ailments
-Dizziness, palpitation, or shortness of breath due to meditation
-High or low blood pressure
-Heart Problems
-Major surgery or infections disease
-If you have been treated for serious emotional or psychological symptoms

Please briefly state the nature of each problem and the current condition:

By clicking "Send Application", I testify that all the information I have provided Tallahassee Chan Center is correct and complete. I understand that if I withhold any necessary information, I may be excluded from future participation. If I am accepted, I agree to finish the entire event. I understand that if I leave the event without permission, my application to future events may not be accepted. You will need to sign a liability waiver prior to attending the retreat.