Aratika Supportive Cancer Care Retreat Oct 31 - 03 Nov 2024 - Paradise Valley Lodge, Rotorua
Welcome please register here to place a booking for our Aratika Cancer Supportive Cancer Care Retreat
Thur Oct 31 - Sun Nov 03 2024. We will contact you by email to confirm your registration of interest. 

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Email *
Full Name *
Contact Phone Number *
Date of Birth *
Age as of Registration *
Full Postal Address, Including nearest City *
Ethnicity (used for funding purposes)
Accomodation Options *
Required
Name, email and mobile phone number of support person if bringing one.
What type of cancer do you have? Can you manage your own health needs day to day? *
Please share with us how you heard about Aratika Cancer Trust - It's helpful for our community connection.
Would you like to be added to our newsletter database? - These are monthly and are the best way to keep up to date with all of our programmes and events.
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Is there anything you would like to us to note, special requests or other queries? We are here ready to listen.
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