Healing Healers
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Registration form - Healers ReTreat
Full Name
Email
Contact Number
Emergency Contact Number
I understand i will be required to take out insurance and that this is my responsibility.
Should we be aware of any special dietary requirements (e.g. vegan, lactose intolerant, gluten sensitivities, etc.? If yes, please describe.
Should we be aware of any allergies/sensitivities (e.g. foods, environmental, perfumes, etc.)? If yes, please describe.
Should we be are of any existing physical or mental health conditions that may impact your comfort or ability to participate in any of the activities (e.g. high or low blood pressure, recent injury or surgery, etc.)? If yes, please describe.
Please advise of any accessibility requirements you may have.
Ticking this box I confirm I will you have at least 6 months left on my passport from May 2025
What are your main goals or intentions for attending this retreat? What do you hope to gain or experience during your time at the retreat?
What is your preference for accommodations?
Single Occupancy
Shared Occupancy (Twin sharing)
Please use this space for any additional information or comments that may help us to improve your retreat experience.
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