Nature Culture Regeneration Booking Form
Please fill out the form as fully as you can, so we can make the weekend the best it can be.
Your place will be confirmed when your deposit has been received.
Your details
Name *
Your answer
Name you would like to be called by *
Your answer
Gender
Age
Your answer
Address
Your answer
Postcode *
Your answer
Telephone numbers (landline and/or mobile) *
Your answer
Email address *
Your answer
The name of someone we could contact in an emergency. *
Your answer
Emergency contact - their relationship to you *
Your answer
Emergency contact number *
Your answer
Do you have any special dietary needs? (Please make it clear if you are highly allergic to something)
Your answer
Other needs, ie mobility, learning difficulties, allergies, health challenges...
Your answer
Which program are you booking onto? *
Your Investment
You have a choice of how much to give for this weekend, based on whether you consider yourself to be abundant income, moderate income or low income. Please bear in mind when choosing that there are a number of us putting considerable time into making this weekend amazing and also be true to yourself when choosing. The options are £230, £200 or £170 Prices include all food and camping for the weekend.

A deposit of £50 is required to reserve your place; the remaining balance is to be paid by 18th September 2018. All bookings after this date require payment in full. The deposit is non-refundable unless it should be necessary for us to cancel this course for any reason.

Payment details:
Peter Cow
Sort code: 08-92-73
Acct no: 88089250

Please put your name and NCR as the reference and email Peter with details of it when you sent it.

Cheques made payable to Peter Cow can be sent to - Dodbrook Farm, Michelcombe, Newton Abbot, Devon. TQ13 7SP

How much are you choosing to pay? *
How much are you paying now? *
More about you to help us shape the weekend
The more we know about you the more we can tailor the weekend to suit everyone present.
What are your intentions for this weekend? What do you hope to get out of it? *
Your answer
What other events or courses of a related nature have you attended, when and who with (e.g. nature connection, bushcraft, community building etc.)?
Your answer
What other related knowledge/experience/skills do you have?
Your answer
How did you hear about the weekend? *
Your answer
For more information or if you are stuck with any of this -
Please get in touch with Peter on 01364 631436 or peter@8shields.org

Thank you for your time.
In gratitude,
Peter, Rebecca and the team

Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service