Under 18 Attendee Application

Under 18 Attendee Application

Full name of minor*

Age of minor*

Date and location of event minor wishes to attend*

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Which type of event are you requesting?*

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Please review the text below

In order to be considered for an Advanced Follow Up Retreat, ALL APPROVED REGISTRANTS MUST FIRST COMPLETE A WEEK LONG ADVANCED RETREAT. Has your child completed a Week Long Advanced Retreat?

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Your application does not meet the criteria

An Advanced Follow Up Retreat is a learning progression which follows the Week Long Retreat. Once a student successfully completes a Week Long Retreat, they are eligible to attend an AFU.

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Parent/Guardian Full Name*

Parents/Guardian Email Address*

Relationship*

Email Address Minor Will Register With*

Has your minor previously attended a Retreat?

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What is the amount of exposure your minor has had with this type of work?*

Does your minor have any mental or physical illnesses?*

If yes, please explain here

I guarantee that my minor can sit through and participate in 12 hour days of lectures and long meditations*

Yes

I understand that during the retreat, there may be loud music, certain screams from people having an internal experience and involuntary movement of people’s bodies that my minor should be mature enough to handle*

Yes

I understand that if my minor is authorized to attend the retreat but becomes disruptive in any way, I - along with my minor - may be asked to leave the ballroom or the retreat*

Yes

Comments / Notes

I take full responsibility for my child.*

I understand that Encephlaon, Inc and the hotel venue are not responsible for my child in any way. I agree to attend the event in full with my child. Please type your name below, this will act as your signature, agreeing to the above.

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