The Crucible Project Weekend For Men

Choose a Weekend

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Event Date*

Mexico Event Dates*

Attendee Information

PLEASE NOTE - If you are registering to attend the weekend or making a payment, provide YOUR information below. If you are registering or paying for someone else, provide THEIR information below only after the person you are registering has agreed to attend the weekend, has given you permission to complete their registration and/or is allowing you to provide a payment on their behalf..

Attendee Name*

First Last

Attendee Email*

Attendee Phone*

Attendee Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Payment Information

PLEASE NOTE - Every registration must include a deposit. The recommended amount is $100. However, a minimum of $10 is required. If needed, we will work with you, through our Financial Assistance program, to find ways to cover the cost of the remaining balance.

Crucible Weekend Registration

Price: $0.00

Options*

Deposit (Non-Refundable)This $100 deposit is non-refundable but may be applied to another weekend within 12 months
BalanceThis $495 payment is non-refundable but may be applied to another weekend within 12 months
Full Payment$100 of this payment is non-refundable but may be applied to another weekend within 12 months
Custom AmountCheck this box to specify the dollar amount you want to make as a deposit or payment

Enter your custom amount below*

Enter a dollar amount between $10 and $594 below. Any amount of $100 or less is non-refundable but may be applied to another weekend within 12 months.

Financial Assistance

The Financial Assistance program was created to assist you in securing the funds that are needed to pay the remaining balance of your registration fee. Check this box to have someone contact you with details about the program.

Total

Your registration requires a deposit. The recommended amount is $100. However, a minimum of $10 is required.

$0.00

Credit/Debit Card*

American Express

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Visa

Card Number Expiration Date Security Code Cardholder Name

Payment Confirmation Email Address*

Specify the email address to which the payment confirmation will be sent.

Comments

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