Defence Wellbeing Retreat 2021

Defence Wellbeing Retreat 2021

Application & Consent Form
Located at the Club Tropical Resort, Lee Point, NT.

Sessions start at 9am and run till approx 4.30pm each day, 28 Aug till Sunday 29 August.
Full Name *

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *
Best Contact Number
E-mail *
example@example.com
Emergency Contact Name: *
Full Name
Emergency Contact Number: *
Phone number
Posted Unit *
ADF Unit
1. Are you Physically & Medically well? If no, Please specify below; *

Yes No
2. Can you participate in high intensity activities? (I.E Zumba) If no, Please specify below; *

Yes No
3. Do you have any medical conditions or injuries? If yes, Please specify below; *

Yes No
4. Do you have any allergies, intolerances or dietary requirements? If yes, Please specify below; *

Yes No
If required to specify more details, please provide below;
*Answering this question will NOT exclude you from the retreat, it will be used to guide retreat activities to suit the needs of each guest, where possible.
I will be available to attend as a *

Day Guest ($49) Overnight Guest ($79)

Which wellbeing topics interest you? *

Other topics of interest to you?
Do you require childcare, If yes please list the children ages with a comma between each age;
How did you hear about this event? *
Do you agree to be open minded during the retreat? *

Yes No
Should be Empty:

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Located at the Club Tropical Resort, Lee Point, NT.