Enlightened Homes MCWS | Refined Heart

REGISTRANT INFO

Full Name *

Gender *

Phone *

Email Address *

Age *

City *

State/Province *

Country

How many accompanying adults (14+)? (If none, enter "0") *

How many accompanying children (0-13) will need child care? (If none, enter "0") *

GROUP INFORMATION

Name *

Age *

CHILDREN INFORMATION

Child Name *

Child Age *

CONSENT AGREEMENTS

Attendance Policy

Electronics Policy

Payment

$15 per adult and $10 per child (0-13) are the registration costs for the program. This includes cost of meals, child care, and general accommodations.

Payment Type *ZelleCredit Card

Attendance Cost

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

Credit / Debit Card *

For any questions or concerns, please contact us at admin@refinedheart.com.