MOON TIDE RETREAT REGISTRATION

PERSONAL DETAILS

Full name

Preferred name

Birthday

Day

Month

Year

Phone

Email

Emergency contact details:

Name

Phone number

HEALTH & WELLBEING

Do you have any medical conditions we should be aware of in case of an emergency?

Do you carry any medication that may be required during the retreat?

No

Yes

Do you have any accessibility requirements or support needs?

No

Yes

CAMPING & ACTIVITIES

Have you camped before?

Yes

No

Do you have your own camping equipment?

Yes

No

Are you comfortable participating in gentle movement activities such as beach pilates and walking?

Yes

No

Unsure

(Please note all activities are optional and can be modified to suit your needs)

RETREAT EXPERIENCE

What inspired you to join Moon Tide?

What are you hoping to receive from this retreat?

Is there anything you'd like the facilitators to know before the retreat?

Do you have any questions about the retreat?

MEDIA CONSENT

Photos and videos may be captured throughout the retreat for Salty Souls promotional content.

I am happy to appear in photos and videos.

I am happy to appear in group photos only.

Please do not include me in any photos or videos.

AGREEMENT

I understand that I am responsible for my own wellbeing and participation during the retreat.

I understand that camping and outdoor activities involve inherent risks.

I have read the event information and packing list.

I agree to treat fellow guests, facilitators and the campsite with respect.

Signature

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Excited to adventure with you!! Jade x