Customer Information Form (Retreat Guest)

Customer Information Form

For Retreat Guests
CONTACT INFORMATION
Contact*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Location: Town / City*
Country*
Profession*
Other
Please specify
Your Role*
Describe in a sentence or two what you do on a daily basis.
Preferred Method Of Contact (select all that apply)*

PhoneWhatsAppEmail
How Did You Hear About Us?*
Other
ATTENDING RETREATS
What type of RETREATS are you interested in (select all that apply)*

Wellbeing RetreatTeam Building RetreatBespoke Corporate RetreatBespoke (Private) Family and/or Friends RetreatAdventure RetreatCreative Retreat (Cooking Classes, Dance Classes, Arts & Crafts, Photography etc.)Other (please specify below)Bachelorette RetreatPost-Wedding RetreatOther
What type of ACTIVITIES are you interested in (select all that apply)*

WorkshopsEducationalNetworkingOutdoor ActivitiesMindfulness & RelaxationCreative SessionsOther
Other
Preferred DATES or TIME of the year*
Please be as specific as possible or state if you are flexible in regards to months and dates.
Preferred LOCATIONS*
Please be as specific as possible or state if you are flexible in regards to locations.
Preferred Length Of Retreat (select all that apply)*

Weekend Retreat (3 nights, 2 days)3-5 Days7 DaysUp to 10 Day10 - 14 Days
Any dietary restrictions or special needs?*
What Are Your Goals & Intentions?*
OTHER INFORMATION
Is There Anything Else You Would Like To Share?
Thank you so much for your interest in our services.

We will be in touch with you shortly.
Should be Empty:

Customer Information Form

CONTACT INFORMATION

ATTENDING RETREATS

OTHER INFORMATION