The Call of the Wild for Women
Private and Confidential
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Name *
Email *
Mobile Phone Number: *
Name of Next of Kin and Telephone Number: *
Your Organization (if any) *
Where Did You Hear About Us? *
How are you planning to arrive and depart to the programme? Please provide details upon booking transport. *
Dietary Restrictions: we will enjoy a hearty brunch and an early supper each day. Each participant will be asked to bring ingredients to prepare one meal (in our fully equipped kitchen) during the retreat. All food will be vegetarian and we can only accommodate food restrictions for severe medical conditions.              
Please share if you have a dietary restriction below.
Do you suffer from any of the following conditions? *
Required
Do you suffer from epilepsy? *
Do you suffer from any other condition requiring that we should be aware of including previous injuries, medical treatment and medication? *
Are you allergic or sensitive to any medication (e.g. Penicillin), insect bites or food? *
Are you taking any form of medication on a regular basis? (If so please ensure that you have adequate supplies of medication for your entire visit) *
Please provide any additional appropriate information concerning your health: *
In order to participate in an Art of Rewilding retreat it's essential that you have read through and agreed with our Booking & Payment Policies which you can find under the PROGRAMMES tab on www.theartofrewilding.com.

We will email our Terms and Conditions to you in PDF form. which will be emailed to you in PDF form. Please take some time to read through it. When you write back to confirm your place you will also be confirming that you have read through, understood and agree to the Terms and Conditions agreement between yourself and The Art of Rewilding.
By clicking 'Yes' below you confirm that you have read through and understood the Terms and Conditions agreement, and The Booking and Payment Policies  between yourself and The Art of ReWilding. *
Required
To confirm your place we ask for payment of the deposit £295 with the remainder of payment due 60 days before the start date.

Please use your last name as your reference when paying into the bank account below and drop us a quick email when you have made the transfer:                                  
Bank name: Triodos. Account name: Natasha Lythgoe   Sort code: 16 58 10 Account: 21375186 International Payments: Swift Number: TRIOESMMXXX.                                  IBAN: GB98NWBK60000410018573
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