Registration Form
​Mother and daughters: Rewiring Together
February 21-23, 2025
Please complete a registration form for each attendee

    Basic Info


    Hopes and reflections


    ​Travel

    Dietary Restrictions

    Please note we may not be able to accommodate all dietary needs, we’ll let you know if you’ll need to supplement with your own food.   


    ​Additional Information

    Deposit Payment Options

    Total cost: $2000. If this cost is prohibitive for you, please ask us about our scholarship program.
    Date of Course: February 21st-23rd, 2025
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    Once you have completed this form please click the
    "Submit" button to finalize your registration