Heart-Mind Qigong Retreat

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Payment and Cancellation Information please click here (The link opens the FAQs in a new tab/window. After reading you can return to this window to complete the form)

Please share your reasons for attending the retreat and what you are hoping to gain from it *

Your previous experience - are you * new to Qigong
a casual student
a long-term practitioner
a teacher

Please list any injuries, illnesses, medical conditions, allergies or anything else you think we should know about in the interests of your safety and well-being, and to ensure you receive the best care

Do you have any special dietary needs, foods you are allergic to, or any other food related requests?

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Please note: Instruction in Qigong is not a replacement for medical advice, diagnosis or treatment of health conditions. If you have an acute or chronic ailment please seek medical attention from a qualified doctor. Some Qigong exercises may not be suitable for everyone. If you are unsure about the suitability of Qigong for you please contact Shirsha.
If you have any injuries or medical conditions that you think may affect your ability to participate, please consult with your medical practitioner first.

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After filling the form please select any of the payment buttons below and pay your $500 deposit , which confirms your booking. If you experience any difficulties submitting this form, or you do not receive a reply: please send us an email.

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