Restore and Renew: Birth Worker Business Retreat

Name*

First NameLast Name

Email Address*

primary phone number*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How did you hear about this retreat? (please be specific - if it was a website, which one? If it was Facebook, what page/group? If it was a person, what is their name so that I can say Thank you!)*

Describe your professional education, training, and experience with the perinatal period:*

Would you characterize your learning style as primarily audio, visual or kinesthetic?*

What do you hope to gain from attending the retreat?*

We will do our best to work with everyone's dietary needs. Do you have any food allergies that cause an anaphylactic reaction? Do you have an special dietary needs? *

Payment, refund, and cancellation policies: By checking below and by submitting this form I agree to the following terms and conditions:

There are no refunds except upon cancellation of the retreat by the organizer, Laura Nance.

I may transfer my registration to another event with Laura Nance within 12 months of the original retreat date with approval from Laura Nance and by paying a transfer fee.

If I fail to transfer to another event within the 12-month period, I understand I will not receive any refund for any monies paid to the organizer, Laura Nance.

In the event of inclement weather, technical issues, or other issues that make it impossible for Laura Nance to hold the retreat on the scheduled dates, new dates will be scheduled. Laura Nance is not responsible for any expenses incurred.

If I fail to pay the balance by October 15 I will lose lose my spot at the retreat with no refund of the deposit.

Yes, I have read and agree to all payment, refund, and cancellation policies.*

yes, I have read and agree

Investment

King Bedroom to self 1297.00

Queen bedroom to self 1097.00

Queen Bed to self, shared room 997.00
Full bed to self, shared room 997.00

Twin bed to self, shared room 897.00

Full bottom bunk bed to self, bunks and room shared 897.00

Twin top bunk to self, bunks and room shared 797.00

If you are interested in sharing a bed with a friend contact me for a discounted rate for both of you.

House is oceanfront with lots of space, a pool, and hot tub.

A deposit of 250.00 will hold your spot, with the balance due by October 31.

Payments after October 31 will be full payment

My Products (contact me to pay via Venmo)

King Room -deposit$450.00

Queen Bed (shared room) Deposit$250.00

Full Bed shared room$1,197.00

Queen Bed (room to self) Deposit $250.00

Twin Bed (shared room) Deposit$250.00

Twin Bed Top Bunk (shared room)$250.00

Full Bed Bottom Bunk (shared room) Deposit$250.00

waiting list $ Free

Enter coupon

Total $0.00

Credit Card

Date