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The Liberation Chapter retreat — Intake Form

We are looking forward to welcoming you to the House of Inquiry. This short form helps us prepare for your arrival with care, so that your stay feels comfortable, well supported, and attuned to what you need during your time with us. Filling in this form doesn’t commit you to a booking — it helps us hold a place for you while we confirm details together.

Your details

Email

Name

Phone number, including country code

What are your main hopes and intentions for participating in The Liberation Retreat?

Room preference

First-choice room

Second-choice room

Third-choice room

If none of your three preferred rooms is available, which aspects of your accommodation are most important to you?

Double bed

Kitchenette

Short walking distance to the main building

Terrace or balcony

No preference

Would you be willing to share a room with another guest?

Yes — I’m rooming with a friend (please share her name below)

Yes — I’d like to share, but don’t have a roommate yet (we’ll pair you with someone)

No — I’d prefer my own room

House of Inquiry is set within six hectares (15 acres) of hilly land. The walk between some accommodation and the main group meeting area may involve several hundred metres of uneven uphill and downhill terrain. Would this present any difficulty for you?

Yes

Health & wellbeing

Is there anything about your health or wellbeing you'd like us to be aware of?

Let us know if you’re vegan, vegetarian, or have any allergies or dietary needs we should be aware of.

Accessibility

Please let us know if you have any specific accessibility, mobility, or communication requirements (such as wheelchair access, sign language interpretation, or seating preferences) so we can make the necessary arrangements.

Anything else

Is there anything else you would like us to know to help us make your stay as comfortable and supportive as possible?

Agreement

I’ve read and agree to the Terms & Conditions

I agree