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Event registration
Forest Therapy Experience
www.NatureWithHaida.ca
Contact us at (604)989-3600 or haida@naturewithhaida.ca
Email address *
YOUR INFORMATION
Name *
Your answer
Phone number (cell phone if possible) *
Your answer
Your Birthdate (for birthday gifts and statistical data)
Your answer
Mailing Address (for birthday & holiday gifts)
Your answer
FOREST THERAPY EXPERIENCE DETAILS
Date of Forest Therapy Experience *
MM
/
DD
/
YYYY
What is your main reason for wanting to experience guided forest therapy? *
Your answer
How would you rate your Nature Connection Today? *
Not well connected
Strong connection
How would you rate your Nature Connection when you were a child?
Not well connected
Strong connection
HEALTH CONDITIONS — What health conditions do you have that I as your guide should be aware of? *
(Include physical abilities - are you able to bend knees? walk up and down small slopes?) If you have no health conditions please enter NONE
Your answer
FOOD ALLERGIES — Do you have any food allergies that I should consider? *
If yes, what are they? Snacks are provided during the wild tea ceremony. If you have no food allergies please enter NONE
Your answer
I have read the Participant Agreement & Waiver *
Your deposit/payment is considered acceptance of the terms outlined in the Participant Agreement & Waiver. Please visit http://naturewithhaida.ca/ftwagreement to review the policies and waiver before completing this form.
Required
How do you wish to pay for your walk? *
We accept eTransfer or Credit Card (via Square). Once your registration form is received I will followup with payment details
Required
Is there anything else you want me to know?
Your answer
STAY IN TOUCH
Signup to receive my newsletter which includes a short story, upcoming events, nature photos, specials and inspirations: http://eepurl.com/cJKJRf
How did you hear of Nature With Haida? *
Your answer
A copy of your responses will be emailed to the address you provided.
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