Wild Retreats – Spain

Date of Retreat

Name on Passport

Date of Birth

Nationality

Mobile Number

Email Address

Address

Town

County

Postcode/Zip:

Country:

Next of Kin:

Contact Number of Next of Kin:

Where did you hear about Wild Retreats:

Comments: Please inform us about any additional information that you feel we should know about for this trip (such as dietary requirements, health or fitness)

I confirm I have read and understand the terms and conditions herein

I confirm I will have appropriate travel insurance at the time of the trip

I confirm I am fit and healthy and have informed Wild Retreats of any possible conditions they should be aware of