Wild + Worthy
a creative women’s collective
Name
First Name
Last Name
pronouns
How do you identify?
Woman
Non-binary
Prefer not to say
Other
Email
example@example.com
Phone Number
-
Area Code
Phone Number
have you experienced a women’s circle before?
yes
no
what inspired you to register for this event?
do you have any accessibility needs or accommodations I need to be aware of? (including allergies or dietary restrictions for refreshments)
Consent + Acknowledgement
I understand this is a facilitated women’s circle and not group therapy.
I agree to respect the confidentiality and privacy of other participants.
I understand there are no refunds within 72 hours of the event.
anything important I should know about you
Tiered Pricing
prev
next
( X )
Community Rate
$
45.00
Quantity
1
2
3
4
5
6
7
8
9
10
Standard Rate
$
55.00
Quantity
1
2
3
4
5
6
7
8
9
10
Supporter Rate
$
75.00
help support another participant
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Total
$
0.00
Save
Register
Should be Empty: