Retreat Booking Form

I would like to book a place on the following retreat: / Date of application:
Retreat Name / Start Date

My personal details are as follows [PLEASE PRINT]:

Name / Home/Contact phone no.
Mobile phone no.
Email address:
Sex: / M / F
Date of Birth:
Post Code / Next of Kin name and phone (in case of illness or accident)

Please indicate how you will be travelling to the retreat. If you tick the “Able to give a lift” box, then your contact details will be given to those people who need a lift. If you do not want your details to be given out in this way, then please tick “Need a lift” and ignore the contact list you receive. The contact list will be sent out with the final information letter about 1 month before the retreat. The origin of retreat attendees is variable and no guarantee can be made that a lift will be available even if you request one.

Able to give a lift / Need a lift
Previous retreat experience:
Special dietary requirements:
Any other requirements:

To book a retreat, complete the form and send with full paymentto the Western Chan Fellowship Membership Secretary at the address bottom-left.You may deduct £10 discount if your booking is paid in full by four months before the retreat starts.Applications without payment will not be accepted. Please make cheques in UKSterling (only) payable to the ‘Western Chan Fellowship’. During 2010 we plan to introduce online booking by credit/debit card – please keep an eye on the website.

If you do not turn up for the retreat, then your fees are forfeited. Cancelling within four weeks of the start of the retreat means that the full fee is forfeited unless we are able to fill your place with another participant. If we are able to fill your place we will return your fee minus £20 cancellation fee.Cancelling a retreat booking more than four weeks before the retreat commences incurs only a £20 cancellation fee with a refund of the rest of the fees paid. If there are significant compassionate grounds for late cancellation the WCF may at its sole discretion refund fees paid other than a £20 cancellation fee, on application in writing to the WCF secretary Dr Simon Child, 24 Woodgate Avenue, Bury, LANCS, BL9 7RU. In some circumstances it is possible to claim for cancellation on holiday insurance, please consider this option if it is available to you. Any remaining credit from a cancellation after recovering expenses will be placed in the Bursary Fund.

Overseas applicants could send their payment as bank note[s]. This will be converted at the prevailing exchange rate on the day of receipt. Any risk of loss of currency in the post is your risk. Alternatively you could make a payment by bank transfer:SWIFT/BIC:CPBKGB22
IBAN: GB77CPBK08929965264205

To:Retreat Bookings
c/o 9 Church Lane,
Elsworth,
Cambridge,
CB23 4HU / The WCF maintains a computer database of our contacts, which is used for keeping you informed of Western Chan Fellowship activities and for notifying local group leaders of possible contacts in their vicinity.Please tickif you do not want to receive any further mailings□ or if you do not wish your details to be passed to our local leaders □.