I’m excited to welcome you onto the upcoming retreat. As part of the onboarding process, I need to get to know you and your needs better. I invite you to fill in the below form.

Name *

First Name

Last Name

Email *

Phone number *

Do you have any allergies? *

Yes

If so, what are the allergies to and how severe is the reaction?

For some of the workshops, Hypnotherapy may be used. Do you have any of the following health conditions: Schizophrenia, Epilepsy, Seizures or Heart related conditions? *

Yes

Do you have any other health or medical conditions you feel we should know about?

Emergency Contact Information *

First Name

Last Name

Emergency Contact Phone Number *

We care about the privacy of your data and will only use this information for the purposes of the retreat you will be attending. In alignment with GDPR regulations we ensure we will be transparent with the use of your data and it will be kept safely and securely. Do you consent to us collecting this data for this purpose? *

Yes

Would you be happy for us to contact you about other retreats and workshops in the future? *

Text

Text and Email

Human Design Workshop

For the Human Design workshop, we need your birth details to calculate your chart. Please enter them below.

Birth Date

YYYY

Birth Time (as accurate as you can)

Hour

Minute

Second

Birth Place (city, country)

Thank you!