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Retreat Enquiry Form
Thank you for your enquiring about the women's weekend retreats.
Please fill in the form below and Ilana will be in touch.
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Email
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Your email
Name:
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Your answer
Address:
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Your answer
Mobile Number:
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Your answer
Emergency Contact Name & Number
*
Your answer
Do you have any food allergies or intolerances?
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Yes
No
Other:
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If you have food allergies or Intolerances, please specify.
Your answer
Are you pregnant?
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Yes
No
Maybe
Are there any injuries or health concerns that I need to be aware of?
*
Your answer
What room type are you enquiring about or have booked?
*
Bunk Room
Twin
Private Room
Other:
Anything else that I need to be aware of?
Your answer
Thank you for filling in this form.
A copy of your responses will be emailed to the address you provided.
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