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Required fields are marked in red.
Gender:
First Name:
Last Name:
E-mail:
You must complete at least one entry of either Home, Work or Mobile phone.
Home Phone No:
Work Phone No:
Mobile Phone No:
How are you travelling to this retreat?
Emergency Contact Name:
Emergency Contact Phone No:
Your Street Address:
Suburb:
State:
Postcode:
Is this your first retreat with the Brahma Kumaris?
How did you find out about this retreat?
What industry do you work in?
Name of person you wish to share
room with, if appropriate:
(ALL PERSONS MUST BE BOOKED INTO RETREAT ON SEPARATE FORM.)
Do you have any medical condition which
is important for us to know e.g. diabetes, asthma?
If yes write in comments box to the right.
Are you receiving treatment or taking any medication for a psychological disorder?
Do you have any special dietary requirements?
If yes write in comments box to the right.