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Birth Time Retreat Booking Form 2022
By completing this form you are booking a place on the Birth Time Retreat 2022.
If this event is cancelled by Every Birth Matters at any point - you will receive a full refund.
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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
Phone Number
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Your answer
Emergency Contact information
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Your answer
Do you identify as
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Female
Male
Non-Binary
Transgender
Intersex
Gender nonconforming
Other
Why are you booking onto this course? What is your specific role or area of interest in midwifery.
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Your answer
Do you have any health issues or a disability?
Your answer
Do you have any specific dietary requirements? eg: Allergies/intolerance/vegetarian/vegan etc
Your answer
Accommodation - what would you like to sleep in?
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Glamping Pod provided (based on 4 sharing)
I would like to bring my own tent
I would like to stay in my own camper
Which bunk would you prefer? Please note we cannot make a guarantee your preference.
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Bottom
Top
Either
Is there any friends/peers you know booking onto this retreat also?
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Your answer
Do you have a special talent that you would happily share with the group? eg: a song, poem, monologue, drumming, play an instrument We are going to be creating our own evening entertainment so please state if you are happy to be involved.
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Your answer
The cost of the retreat is £200 per person.
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I agree/understand
Cancellation of bookings; If for any reason the retreat is cancelled a full refund will be given.
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I understand
Refund policy: Refunds will only be issued within 7 days after deposit is paid. No refunds will be given after this date.
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I agree
Payments must be made along with this form, bookings will not be accepted if payment is not made. The next section will advise you how to make payment.
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I agree
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