Heartfulness Institute of Leadership | Nurturing Humane Leaders

Registration Form

1. PERSONAL INFORMATION

First name

Last name

+Phone / WhatsApp Number+Phone

Preferred Name (for your name tag)

Age (16 or older)

(Please note that in certain facilities, gender-specific accommodations are required, such as separate dormitories)

2. EXPERIENCE & BACKGROUND

3. AGREEMENTS

4. MEALS & DIETARY NEEDS

Vegan and vegetarian meals will be provided (Jan 26-29, 2026). While we may not be able to accommodate all dietary restrictions, we will do our best to support your needs.

Please specify any dietary restrictions or allergies below:

Any dietary restrictions or allergies

5. ACCOMMODATION AND PAYMENT

7. ADDITIONAL INFORMATION

Order Summary

Payment Summary

Cost Item	Deep U Retreat
Program base cost (18% GST included)	₹ 40000.00
Total Amount	₹ 40000

Citizens outside India should select Cards (credit/debit) for payment. Some Visa cards may not work.