Venmo/Zelle Registration Form

Full Name

Email Address

Phone Number

Used only for event-related communication.

Event Name

Payment Schedule

A $300 non-refundable deposit is required to secure your spot. Remaining payments are due by January 10 and February 10, 2026. Full payment details are available on the event page.

Payment Method

Name Used for Payment

Emergency Contact Full Name

Emergency Contact Phone Number

Dietary Needs / Allergies

I understand that the services offered are not a substitute for medical care. I acknowledge full responsibility for my participation and agree to inform the facilitator of any relevant health concerns.

I confirm that I have submitted payment via Venmo or Zelle using the links provided and understand that my spot is not confirmed until payment is received.