It's Time To Go!
You're just one step away from your retreat place.
Just complete the form below and we will confirm everything by return
Here's to the brand new you!
- Personal Details
- Payment Details
- Medical History
Let's start with your personal details
House number & Postcode
Which retreat are you attending (date)
So that we can process your payments, we need your details and authorisation. Please complete all sections below
CARD NUMBER (no spaces)
CARD SECURITY NUMBER
Is this your card?
if no, please confirm who's card it is and you have their permission to charge to it
I give you my authorisation to charge my card in relation to payments relating to this retreat
MEDICAL / FOOD / TRAVEL
Are you taking any medication? If so, please list
Does any of the medication require needle disposal?
Please detail any physical restrictions or reasons you may not be able to participate in all elements of the retreat
Are there any foods you do not eat through religious or personal preference?
Do you have an intolerance or allergy to any food type (please list or state 'none')
We book your flights for you. Please complete the information below