Test

Contact Details

First Name *

Last Name *

Phone Number *

Email *

Postcode *

Personal Background & Information

Age Bracket *

18-25

26-35

36-45

46-55

56-65

65+

Gender identity *

Female

Transgender Female

Non Binary

Gender Non-Conforming

Prefer not to say

Let me describe myself further down below

Other

We're using this information to target future Retreat offers appropriately. We're committed to constant learning, being inclusive and compassionate in our communications - if there is something we could improve upon, or if you want to comment, please email info@jennygarrett.global*

Your field of work *

Teaching, students & education

Mental health & addiction

Retired

Social work, youth work, diversity, equality

Public sector & charities

Environmental, land, gardening & farming

Mindfulness, therapeutic & holistic

IT & tech

Media, arts, creative industries

Other

How did you hear about our retreats? Tick all that apply. *

Word of mouth

I searched online

I saw a post/advert on social media

Via our e-newsletter

Through national or local news/features or advertising (either in print or online)

Other

Have you been on a Happenista retreat/course before? *

Yes

Your Health Needs

Let us know more about your health needs in order to make sure you have the appropriate care while on retreat with us.

This information will remain confidential.

Emergency Contact Name *

Emergency Contact Number *

Please tell us if you have a food ALLERGY, ticking any that apply from this list below. NB: The Trust's kitchens are not allergen-free. *

No special allergy requirements

Celery, including sticks, leaves, spice, seeds, salt & celeriac

Cereals with gluten, including wheat, rye, barley and oats

Eggs

Lupin

Cow's milk

Mustard, including leaves, seeds, flowers, sprouts, spread & oil

Tree nuts, including almonds, hazelnuts, walnuts, brazil nuts, cashews, pecans, pistachios & macadamia nuts

Peanuts

Sesame seeds and oil

Soybeans, including soya flour, soy sauce, soya oil, soya lecithin, soya concentrate, isolated soya protein

Sulphur dioxide and sulphites– including dried fruits such as raisins and prunes

Other

Tell us briefly what's drawn you to this retreat: *

Do you have any physical or mental health issues that may make it difficult for you to participate fully? Please indicate if you have any mobility/medical needs so an appropriate room can be allocated for you. *

Payment Details

Upon pressing Submit, you will be taken to Paypal to make payment of £149 now, and then we will be in touch to ask how you'd like to pay the outstanding amount, instalments are available.

Product

Womens Retreat Deposit: £ 149.00

Total to Pay Today

If you are human, leave this field blank.

Contact Details

Personal Background & Information

Your Health Needs

Payment Details

THINKING THAT SHAPES TOMORROW.

Case Studies

NHS

Coventry City Council

Equans

Test

Contact Details

Personal Background & Information

Your Health Needs

Payment Details

THINKING THAT SHAPES TOMORROW.

Case Studies

NHS

Coventry City Council

Equans

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