NurtureWorks Retreat Registration Form • NurtureWorks Yoga

First Name *

Surname *

Date of birth *

Email *

Phone

Which retreat would you like to book? Please give retreat name and date *

How many places would you like to book? *

If you are booking with others, add their names and email addresses here. Please each submit a registration form

Any comments (eg health issues, dietary requirements, room-share requests, questions)?

Please give details of any Yoga experience and any other forms of regular exercise, if relevant

Would you like to book 'extras' (eg 1-2-1 therapies), if available?

How did you find out about the retreat? *

Would you like to receive my NurtureWorks news (workshops and retreats, class changes, health tips, Yoga and Qigong insights) You can unsubscribe at anytime? *

Yes

No

Prices and Payment

You can pay by credit/debit card through this form or by bank transfer. For bank transfer, please select Other in Payment Options - your confirmation email will include bank details for completing payment. If someone else has already paid for you, just select that option - and be sure to add their name in the relevant field above. Thank you.

Individual booking prices (per person) for two-night retreat. (Please select option) *

Deposit - £150

Full payment - Bed in Triple Room - £350

Full payment - Bed in Twin Room - £390

Full payment - Classic Single - £540

Full payment - Luxury Single - £590

Balance payment - Bed in Triple Room - £200

Balance payment - Bed in Twin Room - £240

Balance payment - Classic Single - £390

Balance payment - Luxury Single - £440

Group booking prices for two-night retreat. (Please select option) *

Deposit - two people - £300

Deposit - three people - £450

Full payment - two people in Twin Room- £780

Full payment - two people in Triple Room- £700

Full payment - three people in Triple Room - £1,050

Balance payment - two people in Twin Room- £480

Balance payment - two people in Triple Room- £400

Balance payment - three people in Triple Room - £600

Payment options *

Pay now with credit/debit card

Other (bank transfer, none right now). Please add details:Other (bank transfer, none right now). Please add details:

Someone else has paid for me

Credit/Debit card payment

Name on card

Credit Card number

Expiry date

Some guidelines for the retreat

Please:

Wear comfortable clothes in layers you can remove and with socks you can take off (not tights) for Yoga sessions.
Clean Yoga mats and other props are provided but please feel free to bring your own. (Fyi - We'll be using mats, blocks, belts, blankets, cushions, bolsters).
Please take a lateral flow Covid test before coming to the retreat. Do not attend if it is positive or if you have any Covid symptoms.
Please be sure you read the Cancellation Policy at the bottom of the retreat description page on my website. This policy still applies for Covid cancellations - I will do my very best to fill your space.
The venue will have been cleaned in compliance with Covid guidelines before our arrival. Face masks are not required at the house, but please feel free to wear one if you prefer.

(You'll receive more details by email before the event).

Declaration

By signing below, I confirm the following:

I declare that the information I have given here is correct and that, as far as I am aware, I can participate in a two-night Yoga retreat without any adverse effects.
I understand it is my responsibility to inform Tiffany of any injury or change in my health ahead of or during the retreat.
I understand that, should I have any concerns about my health during the Yoga practice sessions, I should consult Tiffany before continuing, and my GP if required.
I pledge to listen to and trust my own perceptions above all else as I practise Yoga and to let Tiffany know if something does not feel right or if I am uncomfortable or in pain during or after our session.
I am aware that Tiffany may want to use touch for adjustments in our sessions and I am also aware that I can consent or not.
I have read and accept the terms of the NurtureWorks Retreat and Workshop Booking and Cancellation Policy.
I consent to NurtureWorks processing and storing (in accordance with the NutureWorks Privacy Policy) the personal health data that I have given above to help improve customer experience by keeping Yoga sessions safe and relevant to individual needs.

Signature

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