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Wild Earth Solo Information Form
We are looking forward to welcome you in the Ardennes for the Wild Earth Solo in four weeks! 

Thank you for taking a moment to fill in this form! It will help us to learn a little bit more about you and your intention for joining us.

This form is confidential and your data will not be shared with anyone but Sophie and Carolin.

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What's your full name? *
What's your e-mail address? *
How did you hear about the course? *
Where are you currently based? *
How old are you?
What's your gender and preferred pronouns? *
What attracted you to the course? *
What is your intention for joining this process? Please only answer this question after you've gone on your nature intention walk. *
Please list any psychological and physical conditions that would be useful to know about with regard to your own safety and well-being. For example asthma or allergic reactions to insects or medicine, history of depression, etc.
Do you have any questions or concerns in regards to the course? *
By registering to our programme ”Wild Earth Solo"  you accept the following:  'I understand and acknowledge that my participation in the programme is voluntary. I understand that the programme might bring up challenging emotions at various times. In attending the programme I agree to assume responsibility for my safety and well-being during my Solo experience . I release from all liability and any legal responsibility the facilitators of the programme for any injury, illness, accident, loss, or other misfortune that may occur in connection with my participation in the programme.' *
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