Your Full Name (required)

    Your Contact number (required)

    Your Email (required)

    Your Address(required)

    Number of Family Members Attending Family Camp (required)

    Preferred Accommodation
    DormCamping

    ALL INFORMATION IS CONFIDENTIAL and will be deleted once the retreat has finished. This information is helpful for the facilitator leading the retreat and for the retreat managers in planning the meals and accommodation

    Please fill in details below of each participant.

    Participant 1 (person filling in the registration form)

    Gender

    Name

    Age

    Food allergies or special dietary needs
    Please list any food allergies or special dietary needs that we should be aware of.

    Physical disabilities
    Please list any physical disabilities we need to be aware of (for purposes of getting around, eating, sleeping).

    Medical Concerns
    Please list any serious medical conditions or mental illnesses (such as depression, panic attacks, schizophrenia) that it would be helpful for us to know about

    Medication
    If you are currently taking any kind of medication that we should be made aware of, please enter details.

    Participant 2

    Gender

    Name

    Age

    Relationship to you

    Food allergies or special dietary needs
    Please list any food allergies or special dietary needs that we should be aware of.

    Physical disabilities
    Please list any physical disabilities we need to be aware of (for purposes of getting around, eating, sleeping)

    Medical Concerns
    Please list any serious medical conditions or mental illnesses (such as depression, panic attacks, schizophrenia) that it would be helpful for us to know about

    Medication
    If you are currently taking any kind of medication that we should be made aware of, please enter details

    Participant 3

    Gender

    Name

    Age

    Relationship to you

    Food allergies or special dietary needs
    Please list any food allergies or special dietary needs that we should be aware of.

    Physical disabilities
    Please list any physical disabilities we need to be aware of (for purposes of getting around, eating, sleeping).

    Medical Concerns
    Please list any serious medical conditions or mental illnesses (such as depression, panic attacks, schizophrenia) that it would be helpful for us to know about

    Medication
    If you are currently taking any kind of medication that we should be made aware of, please enter details.

    Participant 4

    Gender

    Name

    Age

    Relationship to you

    Food allergies or special dietary needs
    Please list any food allergies or special dietary needs that we should be aware of.

    Physical disabilities
    Please list any physical disabilities we need to be aware of (for purposes of getting around, eating, sleeping).

    Medical Concerns
    Please list any serious medical conditions or mental illnesses (such as depression, panic attacks, schizophrenia) that it would be helpful for us to know about

    Medication
    If you are currently taking any kind of medication that we should be made aware of, please enter details.

    Participant 5

    Gender

    Name

    Age

    Relationship to you

    Food allergies or special dietary needs
    Please list any food allergies or special dietary needs that we should be aware of.

    Physical disabilities
    Please list any physical disabilities we need to be aware of (for purposes of getting around, eating, sleeping).

    Medical Concerns
    Please list any serious medical conditions or mental illnesses (such as depression, panic attacks, schizophrenia) that it would be helpful for us to know about

    Medication
    If you are currently taking any kind of medication that we should be made aware of, please enter details.

    ==================================================================

    Emergency Contact Info

    Emergency Contact name

    Contact number of Emergency Contact Name

    Relationship to you

    Do you wish to join our mailing list if not already subscribed
    yesNo