Registration Form

Gratitude Getaway Registration Form - PLEASE COMPLETE THE FOLLOWING AND CLICK SUBMIT BEFORE GOING TO PAYMENT AT BOTTOM.

NOTE: Registration is non-refundable. Please contact the Registration Chair if you have already registered but are unable to attend. If you have any questions, please email gratitudegetaway@gmail.com.

Deadline to register is September 1st or when we are at max capacity, whichever is first.

$130.00 registration, meals and lodging included
NOTE: There will be a $5 convenience fee if paying online via the Gratitude Getaway website.

Registration Form

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

Sobriety Date *

Home Group *

T-Shirt Size *

Electronic Signature (Type Full Name Below) *

* I understand everything I've read on this form. Please contact us if you have any questions.

Emergency contact information and any special needs *

We will do our best to meet all requests but cannot make guarantees. Please contact the committee if you have a pressing issue.

How are you paying? *

Please indicate names if paying for more than one person *

Submit

*STOP! If paying online please click the Registration Form SUBMIT button above before clicking PAY NOW

Did you SUBMIT your registration form above? If so, you may proceed with payment below:

Gratitude Getaway Registration Fee

$135.00

$130 GG registration fee plus $5 convenience fee

Pay Now

Gratitude Getaway Scholarship Donation

$10.00

Donation amounts can be done in increments of $10

Pay Now