Register for the retreat!

Tickets	Price
Retreat Tickets	$60.00 (+ $0.00 fee)

Total: $0.00

Scholarship Code

Total

$0.00

Registration Info

First and Last Name

CUA Student ID Number:

Year at CUA

CUA Email

Dietary Restrictions

Allergies

Health Insurance Provider

Policy Number

Insurance Group Number (if applicable)

Emergency Contact First and Last Name

Emergency Contact Relationship to Participant

Emergency Contact Phone Number

Billing Information

First and Last Name

Credit Card

Visa
Mastercard
American Express
Discover

Address

Mobile Phone Number

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Event Ticketing Software by TicketSpice

You will be my witnesses.

Register for the retreat!

Retreat Tickets

Registration Info

Billing Information