Brahma Kumaris Centre for Spiritual Learning
(Baxter) Retreat Registration Form

Please fill in this form for each person booking in for a retreat.
Required fields are marked with asterisk (*).
Please make sure you fill out all fields and press submit button at bottom of form.

*Choose the retreat and date you would like to attend:

*Preferred title:
*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? i.e. health/media/household

If there is someone else on this retreat you would like to share room with, please enter name:
Do you have any medical condition which is important for us to know e.g. diabetes, asthma? If yes write in comments box below.

Comments:

Do you have any special dietary requirements? If yes write in comments box below.

Comments:

Brahma Kumaris Centre for Spiritual Learning(Baxter) Retreat Registration Form

Brahma Kumaris Centre for Spiritual Learning
(Baxter) Retreat Registration Form