Retreat Application Form

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Retreat Application Form FRANCE NEW

Please choose your ticket*
Workshop participation*
Will you be participating in the workshops and pedagogic activities?
Minor registration*
If you will be accompanied by a minor (someone under 18 years of age) you may add them to your registration form here. Otherwise, we ask that you please complete a form for each adult whether they are participating in the workshops or not.
Additional info for accompanying minor*

Please specify the number of minors who will be accompanying you as well as some basic info like names and ages.
Which classes do you plan to attend?*
- All
- Poi
- Staff
We strongly encourage you to attend both poi and staff. What have you got to lose?
What else are you interested in learning?*
- Partner Poi
- Partner Staff
- Double Staffs
- Dragon Staff
- Hula Hoop
- Buugeng
- All
Please inform us of your other areas of interest
Which accommodation option best suits you?*
Dietary Restrictions

Please inform us of any dietary restrictions.
Additional accommodation info

Please let us know about your accommodation preference. Do you prefer to share a room with people of the same sex? Do prefer to be with a friend/ partner/ child? If you are coming as a couple please let us know. We will do our best to accommodate all requests.
Personal Info:
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email*
Date of Birth
MM slash DD slash YYYY
Gender*
This helps us organise the shared accommodation.
Emergency Info:
Emergency Contact Name*
First Last
Relation
Phone
Medical Concerns
Arrival & Departure Info:

Please share your arrival and departure info with us including flight/ train numbers and times so that we can help organize your transportation to the venue. *If you don't have this yet please send it our way once you know
How did you hear about Fusion Arts?*
- Instagram
- Facebook
- Youtube
- Another Website
- Other
Please specify how you heard about us- thanks for your help!*
Message:
Agreements*
- I have read & agree with the Fusion Arts Payment and Cancellation Policy
- I have read & agree with the Liability Release
- I have read & agree with the Copyright agreement and data processing notice
- I understand that I am required to bring my own props. Alternatively, a 10% discount & free delivery is offered to all retreat participants from the Fusion Arts Shop. Orders to be placed up to 30 days prior to the event
Would you like to receive the Fusion Arts Newsletter?
- YES
- NO
- I'm already signed up!
A non-refundable deposit is required to reserve your space for any program. Upon submitting this application, you will be redirected to a payment page where you may pay via debit/ credit card. Applicants must be 18 years of age by the retreat start date.
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Retreat Application Form

Retreat Application Form FRANCE NEW

Personal Info:

Emergency Info: