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Retreat Booking Form

Retreat Name

Date of the retreat

First Name

Last Name

Email Address

Confirm Email

Telephone Number

Age

What do you hope to gain from a retreat at The Barn?

What experience (if any) do you have of meditation?

Do you have any physical health problems? Please give details (e.g. fatigue, back problems)

Do you have any mental or psychological health problems? Please give details (e.g. depression, anxiety)

Do you have or have you had problems with alcohol or drugs? Please give details.

Our food is vegetarian but can include dairy products, eggs and nuts. Do you have any special dietary requirements?

Please give a name and contact number for your doctor, and also details of any prescribed medication.

Name and telephone number of someone we can contact in an emergency:

Is this your first visit to The Barn? If so, how did you hear about us?

The information you supply will be held in confidence and shredded when you leave. We would like permission to keep just your name and contact details on our database - is this ok?

Get in touch

If you would like to know more about the information on this page, please contact:

Name: Barn Manager Tel: +44 (0)1803 732661 Email:barn@sharphamtrust.org

Address: The Barn Retreat, Lower Sharpham Barton, Ashprington, Totnes, Devon, TQ9 7DX