darkness retreat application

If you're interested in a darkness retreat, please fill out the reservation form for an available date according to the calendar. We have two two stays in the dark available, so you can reserve a date even if one person is already booked in the calendar. After receiving your application, we will contact you to confirm the date and send you an invoice for the deposit.

dates

date of arrival:

date of departure:

personal details

name

surname

email (required)

phone (required, used only for communication on the arrival day)

how did you learn about us? (required)

details for the darkness retreat

Is it going to be your first darkness retreat experience?

(if yes, we recommend a preliminary consultation with the guide to direct the preparation for the stay)

your motivation for the darkness retreat:

notes (diet, health condition, etc.):

declaration of fitness to stay in the dark

Dark therapy is not suitable for mentally unstable individuals who are being treated (or have recently been treated) in a psychiatric hospital or are taking antidepressants. It is also not suitable for people with certain types of illnesses, such as epilepsy, etc. Please answer the following questions:

Are you currently, or have you been in the past, under psychiatric treatment?

Are you currently taking any medication prescribed by your doctor?

Do you have any other health problems that your guide should know about?

(for example, high or low blood pressure, heart disease, implanted pacemaker…)

I am aware of my physical and mental capacity to stay in the dark and take full responsibility for any physical, emotional or psychological damage or imbalance that may result from staying in the dark. I release the organizers and operators of the Sklenářka center from responsibility for any physical, emotional or psychological damage or imbalance that would arise as a result of staying in the dark. I participate in the stay in the dark voluntarily, without coercion from another person. By submitting the application, I confirm the truthfulness of the information provided.

By submitting you agree with processing of personal data.