Guest Intake form

Welcome to Vala House's retreat. Please complete the form below.

First name

Last name

Phone

How did you hear about us?

How will you arrive?

Date of arrival

Month

Day

Year

How will you join?

Flight to George

What time do you land?

How will you join?

Bus to Knysna

What time do you arrive?

How will you join?

Self-drive

What time will you arrive?

How will you join?

Other

Do you require a transfer?

Yes

Do you have any food allergies?

Do you have any medical conditions that we need to be aware of?

Do you have any intentions for your time at Vala House, or any goals?

Its there anything else you would like to share

I have read the Video & Audio Taping Release document and consent to its terms. Please note that it is not compulsory to accept.

I accept

I do not accept

I have read the disclaimer waiver, and accept the terms and conditions