The Crucible Project

Are you registering for yourself or someone else?

I am registering for myself

I am registering for someone else

Weekend Information

You are registering for

Retreat Date:

April 23, 2021 - April 25, 2021

Location:

Andover, CT

Gender:

Female

Language:

English

Change retreat

Attendee Information

If you are registering a person other than yourself, provide THEIR information below only after the person you are registering has agreed to attend the weekend, has given you permission to complete their registration on their behalf.

Attendee Name

First

Last

Attendee Contact Information

Phone

Attendee Address

Country

Street Address

City

State/Province/Region

Zip/Postal Code

Payment Information

PLEASE NOTE - Every registration must include a deposit. The recommended amount is $100. However, a minimum of $10 is required. If needed, we will work with you, through our Financial Assistance program, to find ways to cover the cost of the remaining balance.

Options (Select One)

Deposit (Non-Refundable)This $100 deposit is non-refundable but may be applied to another weekend within 12 months $100.00

Full Payment$100 of this payment is non-refundable but may be applied to another weekend within 12 months $595.00

Custom AmountClick this box to specify the dollar amount you want to make as a deposit or payment

Enter Your Custom Amount Below

Enter an dollar amount between $10.00 and $595.00 below. Any amount of $100 or less is non-refundable but may be applied to another weekend within 12 months.

Financial Assistance

The Financial Assistance program was created to assist you in securing the funds that are needed to pay the remaining balance of your registration fee. Check this box to have someone contact you with details about the program.

Credit/Debit Card

PLEASE NOTE - If you are making a payment towards someone else's retreat, fill out YOUR information below.

Payer Name