VITA Wellness CAMP REGISTRATION
Day Passes

STEP 1: Fill out the registration form below and submit.
STEP 2: Pay Deposit - You will be automatically be directed to complete your deposit payment upon submission of this form.
STEP 3: Vita Vie Retreat will process your registration once we have received your registration form and deposit payment.
A confirmation email will be sent to you.

PERSONAL INFORMATION

Name

First Name

Last Name

Phone

Country

(###)

###

####

Number Of People In Your Party

SELECT YOUR DAY PASSES

$175 for each day pass (4.5-5 hours of retreat activities + all nutrition, wellness, and health education guides). Select the dates for each day pass you would like to purchase.

Day Pass #1

YYYY

Day Pass #2

YYYY

Day Pass #3

YYYY

PAYMENT POLICY + AUTHORIZATION

We require a deposit equal to 1 day ($175) to reserve your space. You will automatically be directed to pay your deposit upon submission of this registration form. Day pass balances are due 24 hours prior to your first day of attendance. A secure invoice will be sent 24 hours prior to your first day to complete your balance payment.

I agree to the payment policy.

CANCELLATION AGREEMENT

All day passes must be cancelled 48 hours in advance to receive a refund and/or avoid being charged for that day.

I agree to the cancellation policy.

FULL NAME (as electronic signature)

TODAY'S DATE