Rewilding Retreat Name * First Name Last Name Email * Phone (###) ### #### Date of Birth * MM DD YYYY Do you have any medical conditions? * Any recent injuries or conditions that will impact your ability to practice? * - please note if you are in your 1st trimester it is not recommended to practice yoga Do you have any Allergies? * Yes Not Do you have any special dietary requirements? - Please detail * What is your level of yoga practice? * Regular practice, feel confident Dip in and out New to yoga Never practiced Do you have any accessibility requirments? Have you been on retreat before? Yes No Unsure Where are you travelling from? Any other questions? Are you happy to be in any photos should they be taken? Yes No I'd like to decide later on Thank you for filling out this form. I will be in touch if there is anything we need to discuss in more detail.
