Registration Belgium 2020 - 2022 Aïon Tantra - From Sex To Superconsciousness weekends Application Form Please respond to all the following questions as fully as possible. Do not leave any questions blank. First name * Last name * Email * (Please double check your email address) Phone number * Invoice address * (Street, ZIP code, City, Country) Age * Gender * Male Female Country of residence * Languages I speak * English French Spanish I register for following residential weekend workshops. * Chakra 1 –> October 30th 2020 2:00PM - November 1st 2020 6PM Chakra 2 –> January 29th 2021 2:00PM - January 31st 6:00PM Chakra 3 –> 8. April 16th 2021 2:00PM - April 18th 2021 6PM Chakra 4 –> Jun 25th 2021 2:00PM - Jun 27th 2021 2:00PM Chakra 5 –> 12. October 8th 2021 2:00PM - October 10th 2021 6PM Chakra 6 –> December 3rd 2021 2:00PM - December 5th 2021 6PM Chakra 7 –> February 18th 2022 2:00PM - February 20th 2022 6:00PM Are you participating with your partner? * No - I participate alone Yes - I participate with partner If yes, please give her/his name How did you get to know us? * Why do you want to participat to the chakra week-ends? * What is your personnal experience with Tantra and self-development? * For some people the training can be physically or mentally challenging. It’s important that you let us know whether you have or had any mental problems and of what kind; also whether you use any medication or whether you have been in care or still are seeing a psychologist, a therapist or a psychiatrist. We agree to treat this information as strictly confidential. * It’s also important to let us know about any physical complications and/or health issues, that we should be aware of i.e. illnesses, injuries, allergies, diets, infections etc. * Please give us a contact details of a person we can contact in case of any emergency. Your message for us. Participation Agreement - general rules of the course: 1. Every participant carries full responsibility for themselves and their behaviour, including behaviour towards other participants. 2. Your participation is based upon your voluntary decision for which you take full responsibility. Please understand that all exercises are merely invitational for you, without any obligation. 3. If the organizers or facilitators find that you are not ready for the training or don’t comply with the rules we have the right to dismiss you, in which case we refund your deposit and recommend other forms of self-development / therapy that can suit you better. 4. The course is not a replacement for medical or psychotherapeutic treatment. Certain actions / exercises might be physically or mentally challenging, which is why we ask you to share your past and current medical and mental state with us, including your prescribed medication. We respect your privacy and do not share the collected data with any third party. In case of uncertainty we recommend consulting a medical doctor. 5. Every participant is responsible for their belongings. 6. The course organizers are not responsible for participant’s losses, injuries or physical damage. In case of an injury, the whole cost of medical treatment is covered by the participant. 7. If the participant decides to drop out from the training, they accept the fact that in such case the paid tuition and deposit is non-refundable. 8. The use of drugs, alcohol and other addictive substances is strictly prohibited during the training. 9. I thereby declare that I have answered all the information truthfully and that I agree and will comply with the general rules of participation. Thank you very much for your registration. Before you register please read our Privacy Policy information. Do you accept privacy policy of Tantra Garden? * Yes, I have read participation agreement and I do accept privacy policy of Tantra Garden reCAPTCHA Register