Course Registration Form

ReKindle Registration Form

Fill out the form carefully for registration
Name-Husband*

First NameMiddle NameLast Name
Husband E-mail*
example@example.com
Husband Mobile Number*
Name-Wife*

First NameMiddle NameLast Name
Wife E-mail*
example@example.com
Wife Mobile Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
This is Module One of Four Modules. Select Only One Cohort Group of Your Preference (each cohort covers the same material).

Each cohort will be weekly for 4 weeks. Choose only one cohort group.
Cohort One of Module One
Cohort One-Sunday 11/23 Time: 3pm-4:30pm
Cohort One-Sunday 11/30 Time: 3pm-4:30pm
Cohort One-Sunday 12/7 Time: 3pm-4:30pm
Cohort One-Sunday 12/14 Time:3pm-4:30pm
Cohort Two of Module One
Cohort Two-Tuesday 12/2 Time: 8pm-9:30pm
Cohort Two-Tuesday 12/9 Time: 8pm-9:30pm
Cohort Two-Tuesday 12/16 Time: 8pm-9:30pm
Cohort Two-Tuesday 12/23 Time: 8pm-9:30pm
Cohort Three of Module One
Cohort Three-Sunday 12/21 Time: 3pm-4:30pm
Cohort Three-Sunday 12/28 Time: 3pm-4:30pm
Cohort Three-Sunday 1/4 Time: 3pm-4:30pm
Cohort Three-Tuesday 1/11 Time: 3pm-4:30pm
Cohort Four of Module One
Cohort Four-Monday 12/15 Time: 7pm-8:30pm
Cohort Four-Monday 12/22 Time: 7pm-8:30pm
Cohort Four-Monday 12/29 Time: 7pm-8:30pm
Cohort Four-Monday 1/5 Time: 7pm-8:30pm

Registration*

ReKindle-Marriage Coaching RegistrationRegistration payment goes towards total cost of ($400). All balances due one week before the start of the 1st session. You will be billed for the balance.

$100.00

ReKindle-Marriage Coaching Product Image

ReKindle-Marriage Coaching Pay in full. Payment covers 4 weeks of selected marriage coaching module.

$400.00

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

Afterpay

Should be Empty:

ReKindle Registration Form

This is Module One of Four Modules. Select Only One Cohort Group of Your Preference (each cohort covers the same material).

Payment Methods