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Sign up for Fasting Camp

In order to consider your application for acceptance into the therapeutic fasting camp, please answer the following questionnaire honestly. I note that all personal data you provide will be known only to me and will be used to discern whether a person is ready for the 7 + 3 day water fast.

CAREFUL! All fields are required when completing the form. Failure to complete a field will result in the application not being registered and your registration will not be validated. Thank you.

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Therapeutic Fasting Association
Raiffeisen Bank
RON: RO04 RZBR 0000 0600 2305 1110
EUR : RO74 RZBR 0000 0600 2305 1111

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Name and Surname(Required)

NOTE: The name must be spelled correctly as it appears on the ballot. Please check when entering this field.

Contact phone number(Required)

Email(Required)

Profession(Required)

Weight (in kg)(Required)

Height (cm)(Required)

Social Status(Required)

Age(Required)

Please enter a number from 5 to 150.

Education level(Required)

Vices(Required)

Alcoholic past(Required)

Do you have problems with your bladder?(Required)

Do you have a Spiritual Director?(Required)

Do you snore?(Required)

⁠Do you need the assistance of a clergyman?(Required)

Blood type(Required)

Home address (town and county)(Required)

Report health problems in detail (illnesses, blood pressure, surgeries, medical indications, prescribed medications, etc.)(Required)

Do you ever have food cravings? For baked goods, sweets, or meat? If so, which ones?(Required)

Tell us why you want to go to the therapeutic fasting camp, provide details: Physical; Emotional; Mental; Spiritual(Required)

How is the general social situation? How is it in your family, how is it at work, etc.(Required)

What are your expectations from post-therapeutic therapy?(Required)

Do you agree that to improve your general condition, you should follow the steps of the 7 + 3 day water fast and then practice a more ecological (healthier and spiritual) lifestyle at home?(Required)

Choose Session(Required)

Mentions (optional)

Do you want the assistance of a psychologist in camp?(Required)

Do you have probleme with constipation?(Required)

Your post experience(Required)

Your level of physical activity(Required)

Would you say that you are:(Required)

Where did you hear about this fasting and repentance camp?(Required)

Sign up for Fasting Camp

Support the Therapeutic Fasting Association and its mission

Subscribe to the Therapeutic Fasting Association newsletter!

Invite a friend!

Contact

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