Prince Edward County ~ 'Savour the County' Wellness Retreat Registration Form

Prince Edward County ~ 'Savour the County' Wellness Retreat Registration Form

Please fill out your details to register for the wellness retreat.
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityProvince

Postal Code
What is your accomodation preference?
If you are sharing a room, who would you like to share with?
How would you prefer to pay your deposit?
Would you like a payment plan whereby you pay 50 % of the balance by June 30 and the final balance by July 18 or pay in full by July 18?
How did you hear about this retreat?
To pay by credit card: Deposit Payment Link - Origin Travel

To pay by e-transfer please make payment to: travel@origin-travels.com and include your name + retreat name in the notes
I am aware that the $500 Deposit to secure my retreat space is non-refundable.
Signature
Should be Empty: