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Name (As you would like it to appear on your invoice)
Email
Mobile Phone Number
Invoice Name (Individual name or business name)
Business Name (if applicable)
Billing Address (Street address, city, postcode, country)
Purchase Order Number (if applicable)
Preferred Email for Invoices (if different from your main email)
Accommodation Preference
Twin Share
Single Room (limited availability)
Payment Preference
Pay in full
Payment plan (20% deposit with balance due 4 weeks prior)
What has drawn you to this retreat at this point in your life or leadership?
What are you hoping to gain clarity around during the retreat?
Are you currently leading a business, team, family, or major responsibility?
Yes
No
Prefer not to say
Do you have any dietary requirements or allergies we should be aware of?
Is there anything you feel would support you to feel comfortable and present during the retreat? (optional)
I understand that completing this form does not confirm my place until my invoice has been issued and payment terms are agreed.
I understand that full payment is required no later than four weeks prior to the retreat.
I understand that places are limited and allocated once payment is received.
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