The Midwives' Artist Retreat - November 2019 Registration Form

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Hello! Thank you for signing up for The Midwives' Artist Retreat! Once you fill out this form, you will receive a confirmation email within two business days verifying your spot and giving instructions on how to move forward. If you have any questions, please email emilyritger@themidwives.com directly.

Thank you! We are looking forward to getting to know you better!

Name *

What are your personal pronouns?

Are you a member of Term 3 with The Midwives, or part of our larger Public Community?

Midwives Term 3 Member

Public Community Member

Clear selection

Phone Number *

What is your room preference? Please check all options you would feel comfortable sleeping. *

Two-person Room

Three-person Room

Four-person Room

Large Dorm Room

Private Room (for an additional $75)

Required

Is there another participant you would like to be roomed with?

Which do you prefer:

Same-gender accommodations

Mixed-gender accommodations

No preference

Clear selection

Sliding Scale Rates: $250 - $350 (Term 3 Folks) / $300 - $400 (Public Community). You can choose any amount along that scale. What would you like your contribution to be?

How will you be paying? To ensure your spot, we require a $50 deposit, and full payment by Oct. 18th.

Credit Card (+ small processing fee (3.5% + $.15))

Check

Clear selection

We try to do all we can to make our offerings accessible. Please let us know if you would like a payment plan, or would like to explore bartering options.

Submit

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