REN XUE Africa - Sylvie Jutras Retreats March 2025 Contact DetailsName(Required) First Last Email(Required) Enter Email Confirm Email Phone(Required)Age(Required)16-2425-3435-4445-5455-6465+Gender (for accommodation allocations)(Required)MaleFemaleAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Event DetailsWhich retreat will you be attending(Required)Johannesburg - Farmhouse58 - 7th-9th MarchCape Town - Mont Fleur - 14th-16th MarchBothHow did you hear about this retreat?(Required)Our websiteNewsletterWord of mouthFrom a REN XUE teacherFrom a REN XUE studentInstagramGoogle SearchOtherAre you a REN XUE teacher?(Required)NoYesPlease help us verify our data by confirming the levels you are qualified to teach. All levels 1-6 Level 1 Level 2 Level 3 Level 4 Level 5 Level 6 Question for Sylvie's Q&A sessionPlease feel free to add a question for Sylvie for a scheduled group Q&A session.Emergency ContactWho should we contact in case you require emergency attention during the retreat?Name(Required) First Last Phone(Required)Relationship to you(Required) Medical BackgroundRen Xue Africa will not share this information with anyone other than retreat staff and/or medical professionals called to assist with a health care emergency.Are you currently practicing other body/mind/spiritual practices such as another form of qigong, energy healing, yoga, or any other form of meditation?(Required)YesNoIf yes, please list these Do you have epilepsy?(Required)YesNoAre you pregnant?(Required)YesNoIf yes, what week are you currently in? Have you ever had a mental illness or mental health diagnosis?(Required)YesNoIf yes, please briefly elaborate Do you have any physical disabilities/conditions?(Required)YesNoIf yes, please briefly elaborate Are you suffering from chronic illness or pain?(Required)YesNoIf yes, please briefly elaborate Are you currently taking medication, herbs, or supplements?(Required)YesNoPlease list (if you are comfortable sharing this information) Do you have any allergies?(Required)YesNoWhat treatment do you need in an emergency relating to your allergy/ies? Accommodation OptionsSharing or Private?(Required) Sharing (R7 900 per person) I would like to share with my friend/partner/spouse I would like my own private room (R10 900 per person) Please also tick if you'd like us to allocate you in a room with your friend/partner/spouse.Full Name of friend/partner/spouse Please liaise with your friend/partner/spouse and ensure they are booking within a similar time-frame to you so that we can effectively allocate your wish to room together.Dietary RestrictionsWe will do our best to meet your dietary requirements.Please list any dietary restrictions here Payment DetailsRetreat Fee(Required) Retreat Fee (shared accommodation R7900) Retreat Fee (private accommodation R10 900) HiddenNumber of registrations paid forTotal Cancellation & Refund Policy(Required) I agree with the information listed below.Ren Xue Africa Retreat Cancellation/Refund policy for Sylvie Jutras Retreat March 2025 If you need to cancel your retreat registration, please do so early. Late cancellations make it difficult to give someone else the opportunity to attend and REN XUE Africa has non-refundable, upfront financial obligations to the venue and the guest teacher. Once you have paid the retreat fee, administrative and possibly cancellation fees will apply, depending on the cancellation date. If you cancel your reservation more than: *90 Days before the start date: REN XUE Africa will refund the full amount less an admin fee of R300 *89 – 60 Days before the start date: REN XUE Africa will refund the full amount less 10% cancellation fee plus R300 admin fee. *59 – 45 Days before the start date: REN XUE Africa will refund the full amount less 50% cancellation fee plus R300 admin fee. *Less than 45 Days before the start date: No refund possible Refunds will be issued by bank transfer within 30 days of receiving cancellation notice. Anyone leaving the retreat early for a reason other than a qualifying emergency (medical emergency or a death in the family) will not receive any refund. If someone leaves early due to an emergency (as stated above), we will proportionately refund the days that are not attended minus the R300 admin fee. Ren Xue Africa reserves the right at any time to require that a participant leave the retreat if it is determined that the participant's behavior is either excessively disruptive or dangerous to self or others. In this case, all retreat fees are non-refundable. Cancellation by Ren Xue Africa In the highly unlikely event that Ren Xue Africa must cancel the retreat for unforeseen reasons, we will notify you as soon as possible and will refund the full fee amount paid. Informed consent agreement(Required) I agree with the information listed below. When registering for this event, you are confirming that you have read and agree with the following: I am aware that REN XUE was designed to be a safe, effective, and efficient alternative modality for health and wellbeing, but it also has its limitations. To the best of my knowledge, I have no medical or psychological condition that makes taking part in this REN XUE event not suitable for me at this time – and I assume all responsibility for my participation. I understand that REN XUE and Yuan Gong are not a substitute for medical attention, examination, diagnosis, or treatment. I have read, fully understand, and agree to the terms of this Informed Consent Agreement. I indemnify and release Yuan Tze, REN XUE International, REN XUE Africa, and all people and organizations operating on their behalf, from all liability for personal damage or injury to myself. CommentsThis field is for validation purposes and should be left unchanged. Δ