Transformational Couple’s Retreat Registration Form Participant’s information: Name - participant 1 * First Name Last Name Email * Phone * (###) ### #### Name - participant 2 First Name Last Name Email Phone (###) ### #### Which retreat will you attend? * I will attend the May retreat (May 30th-June 1st) I will attend the July retreat (July 18th-20th) How did you hear about the retreat? * Friend/Referral Social Media Website Other Have you attended a retreat before? * Yes No Do either of you have any dietary restrictions? * Yes No How do you intend to pay for the retreat? * Pay up-front - we will contact you to arrange Installments - please note: a deposit of 25% is due upon registration, with remaining payments due by the first day of the retreat. We will contact you to arrange. Preferred payment method. Credit/Debit Card Bank Transfer Paypal Venmo Date of arrival MM DD YYYY Flight arrival time Hour Minute Second AM PM Date of departure MM DD YYYY Flight departure time Hour Minute Second AM PM Do you need transportation assistance to and from the airport? Yes (if so, we will reach out and provide assistance) No Where do you plan on staying during the retreat? On-Site (already arranged) Off-Site (hotel/AirBNB/etc.) I'm local Do you need assistance finding or booking accommodations? Yes No What are your goals or expectations for the retreat? Are there any specific topics or activities you hope we cover? Do you have any physical, medical, or accessibility needs we should know about? Any other necessities or requests to ensure your comfort and success at the retreat? Emergency Contact - Name * First Name Last Name Email * Phone * (###) ### #### Confirmation * I confirm that all information provided is accurate and complete for both partners. Terms and Conditions * I have read the Terms and Conditions found in the button link below. Thank you! Terms and Conditions
