Wellness & Empowerment Retreat 2024 - Registration Form
Thank you for registering to attend the Wellness & Empowerment Retreat in Costa Rica!  We are excited to have you!  Please complete all required information on this form to confirm your registration.  

Once this form is completed, please proceed to submit payment for the deposit in the amount of $400 USD to secure your spot.  Payment is accepted via cashapp ($dancefitnesstiffany) or paypal (paypal.me/dancefitnesstiffany).  If you are using paypal, please select sending to family and friend or you will additional service fees may apply.  

Your registration is not confirmed until payment is submitted!  Once payment has been submitted and a completed form has been received, you will receive a confirmation email to confirm your registration.    
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What is your first and last name? *
What is your email address? *
What is your phone number? *
What is your room selection? *
Are you submitting the $400 payment for your deposit via cashapp or paypal? (if using paypal, please indicate sending to family/friends to avoid the paypal fees) *
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