Private PDWR 2023 Registration

First Name

Last Name

Phone

Email

Accommodation Status

Address

Address Line 1

Address Line 2

City

State/Province

Zip/Postal

Country

Is there another retreat participant with whom you’d like to share a room? If so, please tell us their name.

Emergency Contact Information

Please provide a name and phone number.

Arrival Date

Departure Date

Payment

Please choose the option(s) you’d like below. The full retreat fee will allow you to attend all portions that are online, including the keynote. If you want to join us in person, please add accommodations and/or meals at Jericho House in Wellfleet, Ontario.

Retreat Costs

I’ve already paid, just filling out registration form

Full Retreat Fee ($199)

Affiliate Discount Retreat Fee ($149)

Presenter Discount Retreat Fee ($75)

Meals and On-Site, Shared Accommodations ($200)

Just Meals, Off-Site Accommodation ($150)

Self-Guided Retreat October 1–4, On-Site ($270)

Self-Guided Retreat Oct 1–4, Off-Site (Just Meals) ($220)

Total

We are accepting international cards, but the total shown will be processed in USD.

Payment

Thank you so much for filling out this registration form!

That’s all the information we need from you for now. We look forward to welcoming you this Fall!

Payment

Thank you so much for filling out this registration form!

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