Getting the Love You Want Registration Full Name (*) Please type your full name. Partner's Name (*) Invalid Input Street Address (*) Enter valid street address. City (*) Enter city. State (*) Enter 2 digit state. Zip (*) Enter 5 digit zip code. Phone (*) Enter phone number. Ex. 404-555-1212 Alternate Phone Enter phone number. Ex. 404-555-1212 E-mail (*) Enter valid email address. Enter Location and Date of the workshop you are registering to attend. (*) Enter Location and Date here. Referred By Enter referred by. Examples include search engine or name of person. Preferred Payment Method (*) Mail a checkPayPalCall in a credit card Please specify how you will pay for this workshop. Authorization (*) I Agree to and understand the cancellation policy and if paying by PayPal would like to send payment now. Check the box to agree. Manuals and food are ordered, and space is rented based on number of couples signed up weeks in advance. Therefore, cancellations are costly, and because of this, the following stipulations apply: • If you need to cancel within two weeks of the workshop, you will receive all but $200 of your payment. • If you need to cancel and there are more than two weeks before the workshop then you will receive all but $100 of your payment. The earlier, the better! Thank you for your understanding and cooperation. Please note: Registration is a two step process. First is to submit this form. Next is payment either manually by check, credit card or via PayPal online.
