Muskoka ~ 'The Golden Pause' Wellness Retreat Registration Form

Muskoka ~ 'The Golden Pause' 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 remaining balance on August 1 and the final balance by September 12 or pay in full by September 12?
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: