Name *

First Name

Last Name

Phone *

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To complete your registration please submit this form and send your tuition (Alumni: $300/Early Bird: $333/Regular: $369/ Deep Dive: $669) via e-transfer to marie-eve@centeredwithin.org *

Got it! I'll send my e-transfer at my earliest convenience to complete my registration and save my spot..

Do you require a formal receipt for insurance purposes? *

Yes please! Email me a formal receipt.

Nope. Don't need it.