"*" indicates required fields RETREAT GUEST INFORMATION FORMPlease complete this form so we can plan in advance to meet your needs. We’d like to know why you’ve booked with us so we can create a great retreat experience for you. We also need to be sure there are no medical conditions that will prevent you from enjoying your time with us. Reclaim Your Self is registered as a Data Controller with the ICO. Your personal data is treated in complete confidence and is protected according to the Data Protection Act/GDPR.1. ABOUT YOUName as in passport* First Last Nationality*Date of Birth* Day Month Year Email* Mobile number with dialling code*Emergency contact name*Emergency contact phone number*2. Your travelAs a Bcorp company we are committed to measuring the entire carbon footprint of each retreat. To help us to do this we need to know your travel details. We appreciate you taking the time to share these. We also need to check your travel matches our transfer options. Thank you.Your arrival flight into TromsoArrival date*Flight number*Your landing time*Your departure flight from TromsoDeparture date*Flight number*Your departure time*Please confirm your ferry plans*Once you arrive at Finnsnes we have a one-hour transfer to the retreat. We will organise a complimentary group transfer on the 17th and 22nd of July, meeting the below ferry times. We strongly recommend booking these ferries so you can benefit from joining our transfers, as they are by far the most convenient and cost-effective option. If you choose to arrive or depart at different times, you’ll need to arrange your own transport, and taxis are around 200 Euro one way. On the 17th July I will travel on the fast ferry departing at 13.45 from Tromsø Prostneset Ferry Terminal to Finnsnes Kai on Senja. On the 22nd July I will travel on the fast ferry departing at 08.45 from Finnsnes Port, arriving back in Tromsø at 10.00. I have other plans Please share your plans here so we know when to expect you.4. INSURANCETravel insurance is essential for all of our trips. When you booked, you agreed to have travel insurance in place that covers you for all of the activities you plan to undertake on your retreat and have adequate cover for travel delay, cancellation and curtailment, medical expenses and your personal belongings. Please provide us with the details of your insurance here. Thank you.Insurance company name*Insurance policy number*5. ABOUT YOUR HEALTHThis section of the form has been designed to identify if any activity might be inappropriate, need adjusting or if you need to take further medical advice. It also gives our team the opportunity to review everyone’s needs in advance and plan accordingly.Do you have or have you had any of the following. Please tick any that apply* Allergies Stroke Cancer Diabetes Long Covid Skin problems Currently pregnant Heart attack/pains in heart or chest Pacemaker Haemophilia Hyper or hypo thyroid condition Epilepsy Back problems Asthma High blood pressure Low blood pressure Bone or joint conditions History of haemorrhage Fainting or dizziness Circulatory disorders or thrombosis None If you have ticked any of the above, please give us more details if necessary - when you experienced the condition, what treatment you had or are having etc.Are you taking any medications/?* Yes No Please let us know what medication/s you are taking6. MORE ABOUT YOUWhy did you book this retreat?* To relax and leave any worries behind for a while To have fun and meet new people To be cared for and looked after To feel physically and mentally better To reclaim myself! To improve my yoga practice To gain tools and strategies to manage stress Please tick any that applyIf you'd like to tell us more, you can do so hereIs there anything that you are concerned about?*How long you have been practising yoga and what style of yoga?*Have you attended classes with this retreat teacher before?* Yes No Midnight sun island experience*For the included Midnight Sun island experience, you can choose to enjoy this either by boat or as a kayak trip. Kayaking: It takes around an hour to get to the island and an hour back, so you need to be relatively fit and confident in a kayak for this option (8 people max). Speed boat: If you prefer to relax, you can opt for the boat trip. We will all meet together on an island to witness the midnight sun. I would like to kayak I would like to go by boat Additional activitiesIncluded in your retreat is: 1 midnight sun island experience (kayaking or a boat trip), 1 e-bike adventure with wild swimming, 1 full day hike to Husfjellet mountain with wild swimming, 1 hike up Sukkertoppen, 1 hot tub, sauna and sea swimming experience. If you’d like to book any additional activities, just let us know which ones from the list below and we’ll be in touch to arrange everything for you. Payment for all pre‑booked activities is collected four weeks before the retreat and are non refundable. Additional kayaking/private island experience (£120 for 4 hours) Additional hot tub, sauna and sea swimming experience (£40 for 2 hours) Arctic gentle body rafting experience (£100 for 1.5 hours) 7. YOUR CONSENTConsent* I confirm that I have read, understood and answered all the questions to the best of my knowledge.*Consent* I have obtained appropriate medical advice and/or consent for any health condition that has been mentioned above and have disclosed all information relevant to my participation in the retreat activities.*Consent* I have declared and received pre-approval for any food allergy or specialist dietary request*Consent* I acknowledge that Reclaim Yourself Retreats are not responsible for any harm caused to me for any medical conditions/allergies not declared or where I have not followed appropriate medical advice.*
