The 'Green Deen' Retreat Form
Email address *
Full Name *
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Date of Birth *
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City of residence *
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Contact number *
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What is your Ethnicity? *
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Do you have any health/medical conditions. If yes please state below *
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Do you have any allergies? If so please list below *
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As part of the retreat there will be periods of outdoor walking. Are you in good physical health? *
What do you do for a living? *
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What experiences do you have with the environment and nature? (This could be anything, from gardening to enjoying nature to active work in the community) *
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Why are you interested in attending the 'Ladies Green Deen' retreat? (max 200 words) *
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Are you available between Friday 9th March (12pm) to Sunday 11th March (5pm) 2018 ? *
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