Ladies Retreat Registration Form with Payment

Retreat Registration
Enter all the names of each person staying in the room.
1st Name *

First Name Last Name
E-mail *
2nd Name

First Name Last Name
Email
example@example.com
3rd Name

First Name Last Name
Email
example@example.com
4th Name

First Name Last Name
Email
example@example.com
Payments are processed through PayPal. You may pay using an existing PayPal account, or any major credit card / debit card.
My Products
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Single-person room (1 King bed) $ 140.00

Two-person room (1 King or 2 Queen Beds) ($90/person) $ 180.00

Three-person room (2 Queen Beds) ($75/person) 3 $ 225.00

Four-person room (2 Queen Beds) ($65/person) 4 $ 260.00

Total $ 0.00
Should be Empty: