Breathe - 2024 Women's Retreat
Friday, February 16 & 17 | Embassy Suites, Destin FL $85 Registration - Plus cost of Lodging ($129)
Name
*
First Name
Last Name
First Time Attending?
*
Yes
No
Age Group
*
20's
30's
40's
50's
60's+
Permission To Text
*
Yes
No
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Would you like a roommate suggestion?
*
Yes
No
Roommates:
Dietary Restrictions:
Questions/ Concerns:
Emergency Contact Name
*
First Name
Last Name
Contact Relation
*
Please Select
Spouse
Parent
Friend
Emergency Contact Phone Number
*
$85 FUMC Registration - Payment Type
*
Bank Account OR Debit/Credit
PayPal/Venmo
Check
Cash
I understand that I have to book my own room at Embassy Suites in Destin at a $129 discounted rate.
*
Yes
Registration Fee Payment
Total Due (Includes Online Fees)
prev
next
( X )
USD
All online payments require a processing fee (3% +.49 per transaction) that will be included in the total due.
Pay with PayPal
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
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the form.
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