Purposeful Pause Registration Form

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Purposeful Pause Registration Form

Early Bird Rate $150.00 (Ends May 6, 2024)

General Rate: $200.00

You may make a 50% Deposit or Pay Full Price Today. All Balances are due by June 10, 2024.

We believe in utilizing payment tools that avoid service fees. If you're not able to pay via Zelle or CashApp, please specify in the notes.

Email *

Payment Options
*

Full Price Early Bird $150.00

Deposit Early Bird $75

Required

Full Name
*

Phone Number

Age Range
*

18 to 24.

25 to 34.

35 to 44.

45 to 54.

55 to 64.

65 or over.

Select All that Apply
*

Retired

Entrepreneur

Full-Time Employed

Part-Time Employed

Student

Volunteer

Currently Looking for Work

Required

How Did You Hear About Us?
*

ZELLE :: You can send money quicker with Zelle®. Enroll by simply adding the retreat email address: hiredtoinspire@gmail.com. Place your full name with Purposeful Pause in the memo section and hit “confirm.” Let us know if you have any questions.

Pay via CashApp - $JonesGirlVibes

ATTENTION: Please make sure you include your full name, along with "Purposeful Pause" in the memo. Scan QR code with your mobile camera.

Are you vegetarian and/or vegan?
*

Yes

Please list any food allergies. If none, list N/A.
*

Are you in need of ADA accessibility?
*

Yes

DISCLAIMERS// By participating in this retreat, you agree to the following: *

Photos and video may be taken at certain points in the retreat with respect for sacred moments.

I hereby agree to indemnify and hold harmless Felisha Jones & Kenya Lewis from any loss, liability, damage or cost, including court costs and attorney's fees, that they may incur due to my participation in said activity, whether caused by personal negligence or otherwise.

I understand that all tickets are non-refundable.

Required

A copy of your responses will be emailed to the address you provided.

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