In light of the coronavirus we ask you to complete this mandatory COVID declaration form for the safety of all our retreat guests. This is a relatively standard form used by hospitality and events.

Note: you do not need to have had a vaccine to join the retreat.

Name *

First Name

Last Name

Email *

Have you experienced any COVID-19 symptoms in the last 14 days? (Cough/respiratory symptoms, high temperature or fever >37.5c, loss of taste or smell, fatigue etc) *

Yes

If yes, have you had a negative PCR test?

Have you travelled to a red list country within the last 14 days? *

Yes

Have you been in close proximity of someone who has COVID symptoms, has travelled to a red list country within the last 14 days or has recently tested positive for COVID? *

Yes

If yes, have you had negative PCR test result?

If you begin to experience any COVID symptoms whilst on the retreat, do you agree to immediately self isolate and tell a member of the retreat team by phone as to not risk their safety? *

Yes

We ask that you take a lateral flow test before you attend the retreat. Do you acknowledge this? *

Yes

Thank you! If you did select yes for any of the answers, one of the team may get in touch with you just to check in.