The 'Green Deen' Retreat Form
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Email address
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Your email
Full Name
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Your answer
Date of Birth
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City of residence
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Your answer
Contact number
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Your answer
What is your Ethnicity?
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Your answer
Do you have any health/medical conditions. If yes please state below
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Your answer
Do you have any allergies? If so please list below
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Your answer
As part of the retreat there will be periods of outdoor walking. Are you in good physical health?
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What do you do for a living?
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Your answer
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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Your answer
Why are you interested in attending the 'Ladies Green Deen' retreat? (max 200 words)
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Your answer
Are you available between Friday 9th March (12pm) to Sunday 11th March (5pm) 2018 ?
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Yes
No
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