Insight Dialogue workshop

first name *

middle name

last name *

M F other *

address *

zip code *

city *

country *

phonenumber *

email *

date of birth *

Meditation: please describe your meditation experience (tradition, practice, duration, number of years) *

How did you hear about this program? *

Is there any other information you would like to share with the teacher(s)?

Other personal information: Do you currently experience major health issues? If yes, please describe. Do you suffer from serious psychological problems, such as addictions, anxiety, depression? Are you currently in therapy? Do you take any medicine for your mental health? Please describe here. * * Please note: answering "yes" to this question does not automatically mean you cannot participate. Since psychological issues / complaints can influence your meditation practice, and vice versa, we like to get in touch with you personally before the start.

Additional comments:

Payment *

This day is donation-based. You can leave your donation on the day.

A minimum donation of CZK 250 is suggested.

€ 0,00

Cancellation policy

I understand that the teacher(s) and other staff decline all liability for any damage occuring to my person or my possessions in connection with this program.

* I agree with the terms and conditions and I register for: Insight Dialogue workshop - 06-05-2022.

After submitting your registration, you will receive an email with the invoice for the program.

Registration Insight Dialogue workshop

a practice day with Lot Heijke May 6, 2022