Divine UK

Residential Retreat Stay Form

Personal Details

Select Retreat

Retreat Start Date

Retreat End Date

For Participant 1

Select a Title

First Name

Last Name

DOB

Add More Participants ?

For Participant 2

Full Name

DOB

Gender

Allergies and Medical Condition

Phone Number

Address

Post code

Country of Origin

Are you traveling from outside the UK?

Current passport issued by

Are you legally entitled to stay in the UK?

Yes

Type of Visa

When do you plan to arrive ?

Other Details

Emergency Contact

Name

Relationship

Phone Number

Address

Do you have any criminal convictions?

Yes

We need to keep the information you give us in this form. We will not share the information with anyone else without getting your permission first, or making you aware

I agree with terms and conditions as well as Short term Accommodation Agreement shown in the above box.

By ticking this box, I am giving permission to store this information on file, and on computer

I confirm that the above information is complete and correct. I consent and will comply with all the points raised in this form. I consent to the processing of this data in the consideration of my application and during my volunteering

Signature