IWA Registration Form

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Island Wellness Cumberland Adventure Nov. 3 - 6, 2023 - Early Bird or Book with a Buddy Price - $1045 total, 50% due immediately upon registration via Venmo - @MiMi-McGee, Zelle 912-230-2829, Cash or Check. Send check made out to MiMi McGee/Island Wellness at 1008 Union St., Brunswick, GA 31520

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Describe any injuries/conditions you might have (use back, if necessary): *

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How far can you walk? *

Are you able to easily get on and off of a boat and in and out of the back of a pickup truck? *

Do you have any food allergies or take any medicines which we should be aware of or which interact with certain foods? *

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