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:*

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? *

What size and cut tee shirt do you wear?

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 of 150.

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.

I understand that if I fail to make my intial payment by the due date there will be a 50.00 late fee assessed with additional late fees added every 30 days.

I understand that if I fail to make the final payment by the due date, I will forfeit my spot at the retreat with no refund of payments already made.

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

yes, I have read and agree

The retreat will be held at a home right on the beach with multiple-bedroom setups. Many rooms have more than one bed and you may have roomates. Everyone will have their own bed.*

To guarantee a room with no roomates there is an upcharge. Limited availability.

*more information below on discounts for sharing a king or queen bed with a friend.

Yes, I have read and agree to all rooming policies.*

yes, I have read and agree

Investment

The retreat days are all inclusive - food and lodging - from Sunday evening Social Hour through Wednesday morning breakfast.

The bonus days pricing is lodging only.

A discount is available for sharing a bed with a friend. This will be a king or queen bed based on availblity. Contact Laura for more information.

There is an upcharge to guarantee a room to yourself.

Spring Retreat - May 4-7
Bonus Days May 8 & 9

Retreat 1350.00
Bonus Days 450.00

Early Bird Pricing available through February 1, 2025
Retreat 1150.00
Bonus Days 350.00

300.00 will hold your place with 1/2 minus 300.00 due by February 1 - a late fee of 50.00 will be added to any payments after February 1 with additional late fees added every 30 days.

The final balance is due by March 23. If I fail to pay the final balance by March 23, I will lose my spot at the retreat with no refund of funds already paid.

Fall Retreat - November 9-12
Bonus Days November 13 & 14

Retreat 1350.00
Bonus Days 450.00

Early Bird Pricing available through February 1, 2025
Retreat 1150.00
Bonus Days 350

300.00 will hold your place with 1/2 minus 300.00 due by May 15 - a late fee of 50.00 will be added to any payments after May 15 with additional late fees added every 30 days.

The final balance is due by September 28. If the final balance is not paid by September 28, the spot at the retreat with no refund of funds already paid.

My Products (contact me to pay via Venmo)*

Spring reserve your spot $300.00

Spring retreat May 4-7

Yes, I would like to add the bonus days! SPRING $ Free

Bonus days price will be added to your invoice for the balance.

Spring No Roommate Upcharge$350.00

Guarantee that you will have a room to yourself with no roommate.

Fall reserve your spot$300.00

Fall Retreat November 9-12

Yes, I would like to add the bonus days! FALL$ Free

Bonus days price will be added to your invoice for the balance.

Fall No Roommate Upcharge $350.00

Guarantee that you will have a room to yourself with no roommate.

waiting list $ Free

Enter coupon

Total $0.00

Payment Methods

Credit Card

ACH Bank Transfer

Afterpay

Date