The version of the browser you are using is no longer supported. Please upgrade to a supported browser.Dismiss

Beyond Trauma & Attachment, Inc. ORLANDO 2017 REGISTRATION
Retreat Frequently Asked Questions--

To register, please answer the following questions---questions marked with an (*) are required.

During the registration process, a $100 deposit for Orlando through PAYPAL *MUST* be made for your registration to be complete. YOUR SPOT IS NOT RESERVED UNTIL A DEPOSIT IS MADE. Your deposit is non refundable.

*You must agree to BeTA's CODE OF CONDUCT and POLICY & PROCEDURES below.* If this creates a problem for you, please contact Rachel DeBruce or Kelly Jo Kallevig before you register.

Once registration has been submitted and processed you will receive a confirmation email. (This may take a few days)

Last Name
Your answer
First Name
Your answer
Your answer
Your answer
Your answer
Zip Code
Your answer
Phone Number
Your answer
Your answer
Event(s) you are registering for:
Have you attended BeTA Orlando before?
Room Type
Deposit of $100 required for Registration. ALL BALANCES WILL BE DUE IN FULL BY December 31, 2016.
Day Visitor Option
Day Visitors: Thanks for choosing to be a part of the BeTA Retreat this year as a Day Visitor! By registering for Saturday and/or Sunday you are welcome to attend any of our classes spread throughout our villas. The registration fee of $25 a day helps to cover our expenses, providing more speakers/classes for you to partake in. Please join the Main House during the lunch hour for a tasty treat and we will have extra goodies just for you. Thank you for respecting the Day Visitor hours of 9am-5pm. We hope in the future you can join us for all the fun, refreshment and learning that takes place over the full retreat. Please take time to read the code of conduct located HERE ( that all BeTA participants must adhere to (you registration marks your agreement). If you have any questions, please email We look forward to spending the day with you!
Villa requested (Orlando)
Please use the name of your Host Mom because the villas may have different names. If you do not have a preference or this is your first year and you are unsure, please select "you pick".
I am sharing a room with:
If you already know whom you would like to room with, please put their name here.
Your answer
Emergancy Contact Name and Phone Number When You Are At Retreat:
Your answer
Allergies, health concerns, dietary information we should know.
Your answer
If this is your first time at BeTA, tell us a little bit about yourself.
What part of trauma or attachment has affected your life? What are you looking to get out of the weekend? Are you more comfortable in a villa that is quieter, hosting fewer activities in the house, or willing to be a part of a more outgoing villa? These questions may help us in placing you in a villa with women of similar situations or desires for the weekend.
Your answer
Do you smoke?
Some villas are strictly smoke-free, so we don't want to accidently place you there. (Yes, No, N/A)
I have read, understand and agree to the CODE OF CONDUCT and BeTA ORLANDO POLICIES & PROCEDURES
Click the following link (opens in another window), read, then come back to this page to check the box below. *PLEASE BE SURE TO READ ALL THREE PAGES*
To complete your registration, you must send a PayPal payment of $100 to PLEASE DO NOT CLICK UNLESS YOU HAVE MADE THE DEPOSIT--YOUR SPOT WILL NOT BE HELD. If you have any concerns with being able to pay or are unable to use paypal, please email to make other arrangements.
T-Shirt size
Please tell us your t-shirt size (male/unisex sizing)
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms