Spring Awakening Day Retreat Form

Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Contact Number *

Country

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Emergency Contact Number *

Country

(###)

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Photography and media consent *

We may capture behind-the-scenes footage during the retreat for use on our website, emails, and social media.

I consent to having my image used in any photos or videos for promotional purposes.

I do not consent to having my image used in any photos or videos for promotional purposes.

I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in this retreat day. *

I agree