AMAZING YOU Women's Retreat- Registration Form

EMPOWERED WOMEN’S RETREAT ‘26

RADIANT
Full Name*

First NameLast Name
REGISTRANT INFORMATION

PLEASE RETURN IMMEDIATELY. Each Person sharing rooms must submit separate registrations
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
Name #2 - Person(s) in Room - ALL Persons sharing rooms must submit Separate Registration Forms.

First NameLast Name
Name #3

First NameLast Name
Name # 4

First NameLast Name
Room Type Selected *
T-Shirt Size
*T-shirts are INCLUDED in your package
Special Diet/Meal Request *
Do You have any Medical Condition we should know about?*

NoneYes, Stated below
State medical condition
Tell us about your medical condition

Transportation Airline details -

	Arrival Time	Airport and Airline	Departure Time	Airport and Airline
Airport Service

File Upload Flight Itinerary.

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PLEASE note PICKUP TIME from Jacksonville airport IS AT 3PM only, and from Gainsville 1:30pm and 3pm. Transportation for Departure from Jacksonville will leave the retreat site at 12:30pm to arrive at the airport by 2:30pm
Bus Commute

Pickup and Drop-off Location is at 5518 W. Oakland Park Blvd., Lauderhill, Fl. 33313.Bus departs at 7:00am Mar. 17th.
Transportation Bus Travel details

City travelling from to Bus location

Bus Service
- Empowered Women's Retreat will provide transportation for the times as stated herein.
- As a patron I am aware of these times and agree to make every effort to honor them.
- As a Patron to Empowered Women's Retreat I agree to coordinate my travel to accomodate the times stated.
- Empowered Retreats will not be responsible to pay for the costs of the transporation of my choice for commute from my point of beginning to the Retreat Site or for travel betwen any Airport, bus or train station and Retreat site.
- Empowered Retreats will not be held responsible for any fees incurred for failure to get patrons to the airport ontime if flight departures are scheduled for times which do not allow for reasonable time for safe commute to the airport.
- Student agrees to pay The full amount prior to the start of the course

- Payments are non refundable but can be transferred to another course in the event the student provides proof of the emergency for withdrawal.
As Patron of Empowered Retreat I agree to the following terms:

ROOMING IS ACCEPTED AS AVAILABLE

Registrations are NON-REFUNDABLE.

**Registrations are NON-TRANSFERABLE.
Registration Selection
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RADIANT WOMEN’S RETREAT 2025Initial Deposit
$100.00 Quantity



Non-attendee DonationSupport
$30.00 Quantity



T-SHIRT
$20.00 QuantitySize



Early bird FULL PAYMENT Complete by NOV. 1st.
$360.00 Quantity



FULL PAYMENT Complete AFTER Nov. 1st.
$400.00 Quantity



PAYMENT Enter additional Amount
$150.00 Quantity



Total

$0.00
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EMPOWERED WOMEN’S RETREAT ‘26

REGISTRANT INFORMATION

Bus Commute