Booking Form for Helping Professionals

Training on 7.10.23

Please complete this form to book your place

Name

First Name

Last Name

Contact phone number

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Occupation

Dietary requirements and allergies

Do you have any additional needs?

Emergency contact

Name

First Name

Last Name

Emergency contact phone number

(###)

###

####

Do you agree to the terms and conditions?

Please read here: https://wildandwellbeing.com/tandcworkshopsevents

Do you agree to photographs of you being used for marketing purposes for future day retreats?

How did you hear about the event?

What attracted you to the event/ what are you hoping to gain from attending?

Is this being given as a gift or as training for a colleague? If so, please write the name of person attending, their email and postal address below

I will be paying

in full

in instalments