Application Form - Creacon Wellness Retreat

Retreat Programme

This application is for the spiritual seeker who is looking to discover and nurture something deeper within themselves. Please complete and submit this form to be considered for the Long Term Retreat Programme.

If you are already part of the programme and wish to extend your stay, download the Renewal Application form.

Your Name (required)

Your Address

Your Email (required)

Your Telephone Number

Emergency Contact Details

Insurance Details or Funds

Do you have any special dietary needs?

Do you have any physical limitations?

Why would you like to participate in an extended stay?

Why have you chosen Creacon Lodge Wellness Centre for your extended stay?

How long do you plan on participating in the extended stay? 3 months? 6 months? 1 year or more?

When would you like to begin this extended stay?

Are you prepared to challenge yourself and build your spiritual endurance? Why?

What goal(s) do you plan to drive towards and achieve during your extended stay?

Have you obtained the appropriate immigration Visas into Ireland, as appropriate?

Have you reviewed and understood the Extended Stay Guidelines?

How did you hear about us?

By submitting this form, I agree to the Creacon Lodge Wellness Centre Extended Stay Guidelines and that the information given on this form is true and factual.

[recaptcha size:compact]