Workshop WaitList

Workshop Details

Which workshop do you wish to attend?

JANUARY 12-19, 2020MAY 17-24, 2020SEPTEMBER 13-20, 2020

Contact Information

Name

Email

Telephone Number

Address

Emergency Contact

Creacon Attendees

Dietary Considerations

Please list any dietary restrictions or if you are a vegetarian.

Accommodation

I am a local resident and do not require accommodation

If you would like to request a specific roommate please add their name below.

Please indicate what room-type you require.

Room with 2 twin-bedsRoom with 1 double bed

Add me to the wait list for a private room (a single supplement charge will apply)

Gender

femalemale

Arrival

Are you arriving late (after Sunday evening)? If so, which day?

Departure

Are you departing early? If so, which day?

Workshop Policy

Upon receiving this completed form, we require a minimum deposit payment of €500 to confirm your application. Eight weeks prior to the event, we require an additional €500 and any outstanding balance will be required four weeks prior to the workshop. The first and second deposits are neither refundable nor transferable. Any amount in excess of the deposit can be refunded up to 21 days prior to the workshop. Within 21 days of the start of the workshop, no refund or transfer is allowed. Please note that your full investment must be submitted prior to the workshop. Thank you for your cooperation and understanding.

I have read and accept these conditions.

By checking this box, and submitting this application, you agree to assume all risks incurred in participating in the workshop including physical injury; and agree to hold Derek OʼNeill and any associated entities harmless for such injury. You further agree that your image may be recorded and used as Derek, in his sole discretion, deems fit. You also agree not to record any part of the session with Derek by any means including audio, video or screen recordings. Please note, we highly recommend that anyone with a history of mental instability, receiving psychiatric treatment or actively taking anti-psychotic medication please seek the advice of your doctor and in doing so attend the workshop at your own risk.

**Please Note: The form will not send unless you check the box above.