The Crucible Project

Retreat Information

You are registering to attend

Retreat Date:

June 4, 2021 - June 6, 2021

Location:

Buffalo Gap, TX

Gender:

Male

Language:

English

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Attendee Information

If you are registering yourself, provide your information below.
Check this box if registering for someone else

Attendee Name

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Last

Attendee Contact Information

Phone

Attendee Address

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Street Address

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Payment Information

Every registration must include a deposit ($100.00 USD), custom amount (between $10.00 USD - $595.00 USD) or full payment ($595.00 USD). However, if paying the deposit and/or the remaining balance will be a financial challenge for you, please check this box to see Financial Assistance options.

Options (Select One)

DepositThis $100.00 USD deposit is non-refundable but may be applied to another weekend within 12 months. $100.00 USD

Full Payment$100.00 USD of this payment is non-refundable but may be applied to another retreat, program or service. $595.00 USD

Custom AmountEnter an amount between $10.00 USD - $595.00 USD. Up to $100.00 USD of this payment is non-refundable but may be applied to another retreat, program or service.

Enter Your Custom Amount Below

Enter an dollar amount between $10.00 USD and 595.00$ below.

Please select mode of payment

Credit Card

Bank Transfer

(Please note: Currently, we accept Bank Transfer for US only.)

Credit/Debit Card

Permissible refunds will be subject to a transaction fee of 15% of the refund amount or 35$, whichever is less.

Participant Agreement Information

I have read and I agree to the Participant Agreement

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Retreat Information

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Attendee Information

Attendee Name

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Attendee Address

Payment Information

Payment Information

Financial Assistance Information

Options (Select One)

Enter Your Custom Amount Below

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Options (Select One)

Please select mode of payment

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Participant Agreement Information