Equilibrium - 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 *
5Rhythms & community with Neil Pinnock
Event Dates & Location information
Friday 20th March - Sunday 22nd March 2020
Location is Wildways Retreat Center, Netherton, Shropshire, WV16 6NJ - wildheartdance@gmail.com - 07761 856154
You can arrive from 4pm on Friday, we will finish at 4pm on Sunday.
Your Details
Neil never passes your details to anybody else.
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 ‘Equilibrium’ 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 to me directly 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 (+ or - 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