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Retreat Enquiry Form 2023
Thank you for your enquiring about my next women's weekend retreat happening in 2023.
Please fill in the form below and Ilana will be in touch once the next retreat dates and details are confirmed.
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Email
*
Your email
Name:
*
Your answer
Address:
*
Your answer
Mobile Number:
*
Your answer
Emergency Contact Name & Number
*
Your answer
Do you have any food allergies or intolerances?
*
Yes
No
Other:
Required
If you have food allergies or Intolerances, please specify.
Your answer
Are you pregnant?
*
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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