REGISTRATION FORM for June 2023 Courage on the Threshold Retreat

Courage on the Threshold

Embracing Life's Changes with Integrity & Grace

June 2-4, 2023 - St. Andrew's House - Union, WA
REGISTRATION FORM
Name
Address
City
State or Province
Zip or Postal Code
Country
Preferred Phone
Preferred Email
example@example.com
What is the best way to contact you?
Special dietary needs or other accommodations (if any)
Emergency Contact Information
Name
Relationship
Best Phone Number
Payment Information
To reserve your space in the retreat, send the completed registration form and a check for the non-refundable deposit of $150 made payable to Spira Consulting LLC to:

Emily Chamberlain

13030 Sunrise Drive NE

Bainbridge Island, WA 98110
If you would prefer to pay by Zelle or PayPal, please email the completed form to

emchamberlain@spiraconsulting.com and check the appropriate box below:
Yes, please send me information about paying by:

Zelle PayPal
Thank you! We welcome your presence and participation in the retreat and look forward to seeing you in June! - Emily & Karen
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Embracing Life's Changes with Integrity & Grace