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Retreat Day Registration Form

Personal Details

Date of birth
Day
Month
Year

Health and Accessibility Information

Please tick any of the boxes that apply to you:

Mental Health Acknowledgement

Have you informed your healthcare or mental health provider that you are attending, and do you agree to update them if your symptoms change?
I have informed my healthcare or mental health provider that I am attending and will update them if my symptoms change.
I am not currently under the care of a mental health or healthcare provider.
I prefer not to say.

Optional Mini Treatments (only complete if you have booked one)

Have you received this treatment before?
Yes
No
Are you currently pregnant or postnatal?
Yes
No

Participant Responsibility

Our retreats are designed to provide a supportive and enriching experience. While we aim to accommodate everyone, it’s important to consider your individual circumstances before attending.


If you have any of the following conditions or are under the care of a healthcare or mental health provider, we strongly recommend you consult them before attending to ensure participation is appropriate:

  • Severe or unmanaged mental health conditions (e.g., schizophrenia, bipolar disorder, severe anxiety)

  • Physical conditions that may limit your ability to participate (e.g., mobility restrictions, recent surgeries, cardiovascular conditions)

  • Conditions that may be triggered by sound therapy, meditation, or group settings (e.g., epilepsy, sensory sensitivities)


By attending, you acknowledge that:

  • You are responsible for your own wellbeing

  • You will participate at your own discretion

  • You will notify us in advance of any support needs so we can make reasonable adjustments where possible

Media Usage Acknowledgement

GDPR Consent

Do you agree for us to contact you about future events, classes or workshops?

We look forward to seeing you soon.

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