Consent Form for Awareness Intensive Retreat

Before completing your registration, please review and provide your consent for the following:

By registering for the Awareness Intensive Retreat, you acknowledge that you have read and agree to our Participation Agreement, which outlines the expectations, responsibilities, and confidentiality commitments of all participants.

Please confirm that you have read and understood our Privacy Policy, which explains how we collect, use, store, and protect your personal data in compliance with GDPR.

As part of the retreat application process, we collect and process certain health-related information (e.g., medical history, psychological well-being, and current medications) to assess your suitability for the program and to ensure a safe experience for all participants. This data is classified as sensitive personal information under GDPR and will only be processed with your explicit consent.

You may withdraw your consent at any time, but doing so may affect your ability to participate in the retreat.

We may capture photos and videos during the retreat for promotional and marketing purposes (e.g., on our website, social media, and brochures). We will always be respectful and avoid using any sensitive or compromising images.

You may withdraw your consent at any time by contacting us, and we will cease using your images in future materials. However, this will not affect content already published.

By clicking "Next", you confirm that you have provided accurate information and that you understand the implications of your consents.

Gender*
Country of Residence*

Are you currently seeing a counselor, psychiatrist, or psychologist?*

Are you now being treated or have you ever been treated for any mental health conditions, including, for example (but not limited to) PTSD, psychosis (including drug-induced psychosis), chronic anxiety, bi-polar disorder, and sleeping disorders that required taking any form of medication and/or hospitalization?*

Have you ever been a patient in a mental health care facility?*

Are you currently taking or have been prescribed psychiatric medications?*

Since you answered yes, please share which prescriptions, for what diagnosis, for how long and the results?*

Have you ever been diagnosed with any type of personality disorder?*

Are you currently under the care of a medical doctor?*

Are you currently taking any medications?*

Do you currently have any communicable diseases?*

What previous "personal development trainings/workshops" have you attended?

Please share why you are interested in Awareness Intensive Retreat?*

What do you hope to take away from attending this event?*

Is there any additional information you feel we will benefit from knowing before you attend this event?

DECLARATION & CONSENT

By submitting this application, I confirm that the information provided is true and accurate to the best of my knowledge. I understand that this information will be used solely to assess my suitability for the Awareness Retreat and will remain confidential.

I consent to the processing of my personal data for the purpose of application review.*

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