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Application form for the July 2024 RECONNECT Retreat with Happy Healthy Georgia
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Why are you interested in joining us for our RECONNECT retreat? *
What are your priorities for this retreat? Choose up to 3. *
Tell us a little bit about you... where are you from, what are your hobbies/interests, what do you do for work, etc. *
What are you hoping to get out of this retreat? 
We would love to hear it in your own words.
*
What is your greatest challenge at the moment? *
What questions do you need answered before you can commit to this retreat? *
Name *
Age *
Email address *
Mobile number and country code
Feel free to add your instagram handle so we can put a face to your name :)
What is your preference of bed arrangements for the retreat? *
If you selected 'Single Room - Single Bed' - Would you be happy to share with someone else if all the single rooms are taken?
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Do you have any allergies? *
Do you have any dietary requirements and/or preferences? *
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