Wilderness Wellness Registration

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We cannot wait to share this experience with you! We hope this retreat will be life changing. A time truly dedicated to yourself; focusing on health and happiness through food, movement and community.
Please fill out for this form to save your spot for the program.

Name

Phone #

Do you agree to be added to the Wilderness Wellness Whatsapp group

Yes

Clear selection

Any allergies / dietary restrictions

What areas of health would you want to improve most?

Mental

Physical

Emotional

Existential

Relational

Environmental

Other:

Since we will be camping overnight:

I have a tent I can bring

I am willing to share the tent I bring

I do not have a tent

I am willing to share someone else's tent

Other:

If you answered that you have a tent and you can share- how many people does your tent sleep? Thank you!

Please bring a sleeping bag (or anything else you'd be comfortable sleeping with) Please mark YES if you understand

Yes

Clear selection

Payment

To save your spot and finalize your registration please send your payment of 490NIS by:
Bank Transfer: Naomi Eastman, Bank Hapoalim, Snif 582, Account # 146260
Bit: 054-650-7179 (please add your name & Wilderness Wellness in the description)

Submit

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