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Name

Address

Phone Number

Email

Date of Birth

Which Retreat/ Course?

Please let us have a few sentences in answer to the following questions

1. What do you hope to gain from this course?

2. What set you on the path of personal/spiritual development?

3. Who and what are your significant influences – teachers, books, events and experiences?

4. Please describe any significant events in your physical and mental healthcare history.

5. Any special dietary requirements.

Please send me details of offers, promotions and news at Swanage Retreats

We hate spam too so will only send occasional offers and promotions and we never give your information to third parties.

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