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Application form
Harmony Wellbeing Retreats
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Email
*
Your email
Harmony House Boutique B&B
Guest lounge
How did you hear about our retreats?
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Your answer
Which Harmony Wellbeing Retreat are you applying for?
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Harmony Wellbeing Residential Retreat - 23-25 February
Harmony Wellbeing Residential Retreat - 17-19 May
Harmony Wellbeing Residential Retreat - 20-22 September
Harmony Wellbeing DAY Retreat - Dates coming soon
If our retreats are oversubscribed would you like to put your name on our waiting list for the next available one?
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Yes
No
Title
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Mr
Mrs
Ms
Miss
Dr
Other:
Name
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Your answer
Address
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Your answer
Email
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Your answer
Telephone (mobile preferably)
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Your answer
If you are applying for a residential retreat, please give your first and second room choice below. We will do our best to accommodate your choices.
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Willow Cottage (2 persons only)
Great Burnet
Poppy
Cornflower
First choice
Second Choice
Willow Cottage (2 persons only)
Great Burnet
Poppy
Cornflower
First choice
Second Choice
Are you intending to share a room with another retreat guest? If so, please give their name.
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Your answer
Please indicate which
one
of the Sunday activities you would like to book on to.
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Wild swimming
Botanical gardens
Quiet time
Do you have any dietary requirements or allergies that we need to be aware of for your stay?
Your answer
Anything else you would like us to know?
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Your answer
What next?
Please email to tell us you have completed this application form on info@harmonyhouseyork.com.
We will then be in touch within 48 hours. Thank you!
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