Phone Gaia House on +44 (0) 1626 333 613 Email Gaia House info@gaiahouse.co.uk Gaia House on Facebook @GaiaHouseUK on Twitter Group Retreat Programme Go to Checkout return to home page

Family Retreat Application Form

[We are sorry, this retreat is now oversubscribed and we are no longer inviting applications for 2017]

  • Allocating spaces on this retreat is complicated as we have to take many factors into consideration.
  • In completing this application, we ask that you reserve the dates in your diary and commit to attending the retreat, should you be offered a place.
Lead Adult - First Name *
Lead Adult - Last Name *
Age*
Gender * FemaleMaleAnother gender identity
Address *
Town/City *
County / State
Post Code*
Country *
Email *
Phone *
Additional phone
Has the lead adult attended a Retreat at Gaia House before? * NoYes
Has the lead adult attended a Family Retreat at Gaia House before? * NoYes
Retreat Rate Preference* Standard RateSupported RateSponsor Rate

Details of Family Group

Please fill in the details of the family group below.

Please provide the ages the children will be at the time of the Retreat. This helps us with our planning.

Second Adult - First Name
Second Adult - Last Name
Age
Gender FemaleMaleAnother gender identity
Has the second adult attended a Retreat at Gaia House before? NoYes
Has the second adult attended a Family Retreat at Gaia House before? NoYes
First Child - First Name
First Child - Last Name
Age next July
Gender FemaleMaleAnother gender identity
Second Child - First Name
Second Child - Last Name
Age next July
Gender FemaleMaleAnother gender identity
Third Child - First Name
Third Child - Last Name
Age next July
Gender FemaleMaleAnother gender identity
Fourth Child - First Name
Fourth Child - Last Name
Age next July
Gender FemaleMaleAnother gender identity
Fifth Child - First Name
Fifth Child - Last Name
Age next July
Gender FemaleMaleAnother gender identity
If any members of your group have specific needs relating to a disability, long-term illness or health condition please provide further information below. Our Outreach Manager will contact you via email to discuss your needs if you are offered a place. Any information you provide is confidential and will only be used in support of your retreat.
Additional information (optional):

Booking and Cancellation Conditions

Payment and Deposits:

  • Retreats up to and including 3 nights: Please pay in full at the time of booking.
  • Retreats of 4 nights or more: A non-refundable, non-transferable deposit of £100 will secure your place. Please pay the balance at least one month before the start date.
  • If you have paid a deposit, an email will be sent to you to remind you to pay the outstanding balance.
  • If you have not paid in full, one month before the start of your retreat, your place may be cancelled (with the loss of your deposit), and offered to someone on the waiting list.

Cancellation and Refunds:

  • If you cancel more than 1 month before the start date of the retreat, the cancellation fee will be £100.
    (For low cost retreats such as Day Retreats, Dana Retreat, Work Retreat or Young Persons Retreat, the cancellation fee will be £10).
  • If you cancel less than 1 month but more than 2 weeks before the start date, the cancellation fee will be £100 or half the cost of your retreat, whichever is greater.
  • Extra nights cancelled more than 1 month before your arrival date will be refunded, less a £20 admin fee.
  • Extra nights cancelled less than 1 month in advance will be charged in full.
  • If you cancel less than 2 weeks before the start date, the cancellation fee will be the full amount paid.

Cancellation fees (less administration costs) are placed in the Financial Assistance and Bursaries Fund (FAB Fund).

Booking conditions may be subject to alteration.
See: Booking and Cancellation.

I have read and agree to the Booking & Cancellation Conditions *

We very much look forward to welcoming you to Gaia House. It is important to us to be truly inclusive and welcome all people. We invite you to contact our Reception team if you want to tell us more about how we can welcome you: Email info@nullgaiahouse.co.uk or call 01626 333613.

* = required