2025 Spring I’tikaf Retreat Registration

REGISTRANT INFO

First Name *

Last Name *

Phone *

Email Address *

Gender *

City *

State/Province *

Country

Occupation

Please list any food allergies

Which portion of the retreat will you be attending? *

Age *

How many accompanying children (ages 2-10) will need child care? (If none, enter "0") *

CHILDREN INFORMATION

Child Name *

Child Age *

Gender *

Food allergies

CONSENT AGREEMENTS

Attendance Policy

Children Policy

Electronics Policy

PAYMENT

$50 for adults (full weekend) or $30 for adults (Saturday afternoon), and $10 per child (0-13) are the registration costs for the program. This includes cost of meals and accommodations.

Attendance Cost

Payment Type *Credit CardZelle

Credit / Debit Card *

By filling this field I authorize Refined Heart NFP to charge my credit card at the amount listed above for the agreed upon purchase(s).

Zelle Transaction IDAddress the zelle payment to admin@refinedheart.com and enter the transaction id here.