If you are at all interested in learning more about the practice of mindfulness and meditation and would like to experience a 5 day teen retreat or long weekend program we encourage you to fill out the expression of interest form, below.

To see information about our upcoming retreats click here.

Click here for Long-Weekend Program information.

After completing the registration form we'll be in touch within the fortnight to speak about what's next.

If you have any questions relating to this form don't hesitate to contact us!

e: enquiries@ime.org.au

 

Apply

Your Name *
Your Name
D.O.B *
D.O.B
Your Address *
Your Address
Parent/ Guardian Name
Parent/ Guardian Name
Is Parent/ Guardian Address Same as Your Address
If no, please fill out the 'parent/ guardian address' flied below. If yes, skip.
Parent/ Guardian Address
Parent/ Guardian Address
e.g. I've tried it before at school or at home | I've heard about it before but haven't tried it | someone I know meditates | I meditate regularly
e.g. you're willing to try new things | you feel confident with speaking to groups of people | you are a leader | you care about the wellbeing of others | you are creative
e.g. talk to a friend or carer | exercise | listen to music | read | write | draw | visit a particular place
e.g. loss of loved one | leaving home | divorce
Dietary and Medical Needs
As our programs are fully catered it’s important we know about any special needs.
If yes, please provide details.
If yes, please provide details.
If yes, please provide details.
Additional Support
To ensure appropriate support for all teens on retreat it's important we know about any extra support you have received/or are receiving from mental health professionals.
Have you in the past or are you currently accessing counselling support through a Psychologist or Counsellor or other professional?
e.g. coping with stress, anxiety, low mood, drug or alcohol use, family or relationship issues. We understand this information may be sensitive and it will be treated confidentially*
e.g. overwhelmed by school/ exams, transitioning to work or tertiary education, conflict with close friends or family.
Celebrating diversity
This information will help us create an environment that supports every teen at the retreat. We realise these categories are limited, yet it will be helpful to us to know if you belong to any of the following:
Please check any that apply
More about you
PAYMENT
Depending on the program you're applying for, select your payment option below.
Retreat Program Cost - We're commited to Accessibilty
Long Weekend Program Cost - We're commited to Accessibilty
We want to ensure this program is accessible to all and understand everyone has a unique set of financial circumstances. Long Weekend costs are all inclusive, including lunch, snacks and a three-day learning program with experienced meditation and yoga teachers and specialist staff. The full cost of the program is $350 per person. This covers produce and catering costs, equipment, venue hire and staff costs and expenses. To make it accessible, we invite participants to select a tier that represents their current financial circumstances. Please select the tier you will be nominating for your place on the program.