Name *

First Name

Last Name

Phone *

You will be added to a Whatsapp group closer to the date to coordinate travel times and broacast info

(###)

###

####

Room option *

Last spot in a twin room or separate single (contact me for details)

Do you have any dietary requirements ?

vegan

vegetarian

nut free

gluten free

other

Have you read and understood our terms and conditions ? *

Link can be found at the bottom of the Cornwall retreat page

yes

Have you paid a deposit of £300? *

Pay to: Luisa Zamboni Sort Code 20 72 91 Account 60063665

yes

no but I will after this