Spiritual Parenting registration for Family (1 or 2 Adults with Children or 2 Adults from family)

Please note the following
This page allows you to register for a family. A family registration is for one or two adults with their child/children attending. If there are more than two adults, please use the Adult registration form for the extra adults.
RM_Stats
Number of Adults^*
Enter number of Adults attending the retreat.
Number of children^*
Enter number of Children attending the retreat
Adult #1 First Name^*
Adult #1 Last Name^*
Adult #2 First Name^*
Adult #2 Last Name^*
Child #1: First Name
Child #1: Last Name^*
Date of Birth of Child #1^*
Child #1: Grade^*
Child #2: First Name^*
Child #2: Last Name^*
Date of Birth of Child #2^*
Child #2: Grade^*
Child #3: First Name^*
Child #3: Last Name^*
Date of Birth of Child #3^*
Child #3: Grade^*
Address

Phone Number^*
Mobile
Email^*
Alternate Email
Any food restrictions or allergies^*
Emergency Contact^*
Emergency Contact Phone number^*
If you are from out of town, and require hotel accommodation. Choose Yes on the next question. We will send you details on the recommended hotel.

Hotel accommodation needed^*
No

Yes

Choose PayPal option to pay online even if you do not have a PayPal account and want to pay using a credit card. A PayPal account is not necessary to pay online.

Select a payment method^*