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Booking Form
Hello,
We are so excited that you are interested in joining us for a farm immersion. Please fill out this booking form and we will get back to you shortly. Then we will send you a link to pay for your immersion.
Contact us at
growwildroots@gmail.com
or 845-701-1738
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Email
*
Your email
What dates/immersion are you interested in booking?
*
Your answer
Full Name
*
Your answer
How many people are you requesting to book for?
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Your answer
Phone number
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Your answer
What is the best way to contact you? Phone or email?
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Phone
Email
Other:
Required
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip code
*
Your answer
Age
Your answer
What is your past experience with camping or rustic off-grid bliving?
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Your answer
What draws you to this program?
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Your answer
What are some of your own passions or creative expressions that you're interested in exploring while you are on the farm?
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Your answer
Do you have any allergies?
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Your answer
What are you excited about?
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Your answer
Do you have any dietary restrictions?
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Your answer
Do you have any physical limitations? Our Farm is spread out and can have rough terrain depending on location and weather
*
Your answer
Are you vaccinated?
*
Your answer
How did you find out about the Farm Immersion Program?
Your answer
Do you have any questions or concerns?
Your answer
Send me a copy of my responses.
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