Prenatal retreat THE NETHERLANDS

Request and book your pregnancy retreat by completing the form below.
We will contact you to provide more details, answer any questions or help you reserve your spot.

Book retreat

request form

NAME & ADDRESS NAME & ADDRESS

First name

Surname

Email

Phone number

Postal code

Street and House number

City

Country

ABOUT THE RETREAT ABOUT THE RETREAT

Which RETREAT DATE would you prefer to book? Which RETREAT DATE would you prefer to book? Retreat date: 27 February - 2 March

Which ROOM TYPE are you most interested in? Which ROOM TYPE are you most interested in? Shared room Private room

ABOUT YOUR PREGNANCY ABOUT YOUR PREGNANCY

What is your DUE DATE ? What is your DUE DATE ?

Please enter your due date

Do you have pregnancy related complaints? Do you have pregnancy related complaints? yes no

Yes, my complaints are ....

ABOUT YOUR TRAVEL ABOUT YOUR TRAVEL

Would you like some support arranging your travel or getting here? Would you like some support arranging your travel or getting here? yes please no, thanks

I have a question concerning my travel:

It's recommended to have a cancellation / travel insurance, do you have one? It's recommended to have a cancellation / travel insurance, do you have one? yes, I do no I don't have a cancellation insurance

I have a question concerning my cancellation insurance:

EXTRA INFORMATION EXTRA INFORMATION

Do you follow a specific diet or do you have allergies? Do you follow a specific diet or do you have allergies? yes no

If so, please tell us which diet you follow or allergies you have?

Do you have injuries or complaints that are not pregnancy related, but that you think we should know about? Do you have injuries or complaints that are not pregnancy related, but that you think we should know about? yes no

Which existing injuries do you have?

Is there anything else that you would like us to take into account? Is there anything else that you would like us to take into account? yes no

Please let us know if there is anything you would like us to take into account...

Do you have any other questions? Do you have any other questions?

More information, wishes, questions?

IN CASE OF EMERGENCIES IN CASE OF EMERGENCIES

Name and number of partner in case of emergency

PLEASE NOTE: When you click the registration button, you will be redirected to Eversport. There, you can complete your payment to finalize your registration. We will contact you for additional information. PLEASE NOTE: When you click the registration button, you will be redirected to Eversport. There, you can complete your payment to finalize your registration. We will contact you for additional information.