Retreat Booking Form

We are delighted that you will be joining us! It would be great if you could fill out this form so that we have a few more details.

Name

First Name

Last Name

Phone

(###)

###

####

Which of our programmes are you booking onto?

What is the name and number of an emergecy contact

Do you have any dietary requirements?

Do you identify as having a disability or do you have any relevant medical conditions? What support would you need in order to attend?

Would you like to tell us anything about how you define your sex, gender or preferred pronouns (e.g. they, she, he, or something else)?

If you'd like to say, how do you define your ethnic identity?

If you'd like to say, what is your age?

How did you hear about Change in Nature / this programme? (Please be as specific as possible).

Do you agree to our Terms & Conditions?

The link to our T&Cs can be found in our website footer

Yes

Do you have any questions for us?

Yes please

No thanks

I am already on it!