| Please print out, complete, sign and return with $50 deposit to : |
Funkey Forest |
| Name : | Ph : |
Address : Email : |
|
| Date of fast you would like to attend : | |
| Have you any current health problems? |
| Note: 3 day fasts are generally fine for most people. However, in some cases of serious medical conditions or eating disorders it may may not be best. If you have a serious condition, please consult your doctor or health practitioner as to the appropriateness of fasting. |
| I would like to ( circle one ) : | Camp / Sleep in dormitory |
| I would like to book ..... massage/s | for duration ...............hrs/mins |
| I enclose a cheque/money order of : | $50.00 Deposit only (non-refundable - transferable to another retreat if at least 5 days notice given prior to retreat start) |
( Please make cheques payable to: FUNKEY FOREST ) |
$295.00 Waged |
| $250.00 Concession |
| I fast and take part in this forest fast at my own risk.
I am totally responsible for anything that happens to me as a result of
fasting or that I incur through my own actions or misadventure during the
retreat. Signed..................................................................Date............................ |