2020 Vision - Booking Form
This event is open to all. Some experience of 5Rhythms is useful but not necessary. Other training and backgrounds are as valid as a willingness to engage through the work offered. To book your place just complete this form as fully as you can.
Email address *
Event Dates & Location information
Sunday 29th December 2019 - Wednesday 1st January 2020
Location is Wildways Retreat Center, Netherton, Shropshire, WV16 6NJ - wildheartdance@gmail.com - 07761 856154
You can arrive from 12 noon on Sunday, we will finish at 6pm on 1st January.
There will be some of us staying one extra night - you are welcome to join us (additional £20).
New year 5Rhythms & Ritual with Neil Pinnock
Your Details
Neil Pinnock does not share your details with anybody or any organisation.
Name *
Your answer
Telephone contact number *
Your answer
Is it ok to add your email to Neil's mailing list? (your details will not be shared - GDPR) *
What is your 5Rhythms experience? *
Payment
Please make payments by bank transfer or by cheque.
Bank Transfer: Sort: 40-07-33 Account: 12032104 (use ‘Vision’ as ref).
Make cheques payable to Mr N Pinnock and send to Wildways, Netherton, Shropshire, WV16 6NJ.
Paypal by request - booking fee applies.
All fees include booking, workshops, shared residential accommodation or camping and facilities at Wildways.
Options *
Bursary scheme
We live in a society with high levels of inequality. Wild Heart Dance runs a bursary fund to assist students who could otherwise not participate. You are welcome to apply directly to whdbursary@gmail.com if you feel money is the only reason that you could not attend. Otherwise, please consider an act of generosity and make a donation to support a participant in financial need.
Please add a donation to the bursary fund *
Final payment amount - Booking + Bursary *
Your answer
I have paid by *
Required
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy