May 28 - June 3, 2027 Melissa Valentine

Name

Date of Birth

What gender do you identify as?

Male
Female
Other

What pronouns do you use?

Phone Number (Mobile Phone preferred)

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By providing your cell phone number you consent to receive limited SMS updates regarding your travel plans.
If you do not wish to receive these, please email [email protected].

Address

Emergency Contact Name (Someone who is not traveling with you who would be able to help in an emergency)

Emergency Contact Phone Number

If you would like to include your photo please upload here.

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Admin Use Only

1. Select your Registration Option.

2. Under Payment Options, select: Full Payment OR Deposit Payment

If you select Deposit Payment, depending on when you registered, your remaining balance will be split into 1 - 3 payments and processed with your credit card on file on the dates indicated on your Confirmation Letter.
Follow THIS LINK to review our payment schedule policies.
Additional payments can be made at any time through your account up to the final auto payment date.

If there is a waitlist for the registration type you would like we encourage you to fill in the registration form and select the waitlist option (no payment necessary). We often find that there are changes to availability and a spot may open up. You may also contact us directly at [email protected] with any questions.

Registration Options

(All Prices in USD)

Single Occupancy ($4,095.00)
Private room, Ensuite Bath Facilities.
Shared Occupancy ($3,695.00)
Up to two people of the same gender per room.
Friends and couples may room together upon request.

Running Total

$0.00

Payment Processing Fee (non-refundable)

$50.00

Total

$50.00

If your occupancy is a shared type, do you have a roommate request?

Yes. If you select 'Yes', you may enter the name of your roommate in the next field below.
No. If you select 'No' we will place you with another registrant(s) of the same gender.

Event Registration Software by RegFox

The Courage to Be: Finding YOUR Way in Connemara, Ireland

with Melissa Valentine

May 28 - June 3, 2027`

Delphi Valley, Ireland

REGISTRATION FORM

PARTICIPANT CONTACT INFORMATION

REGISTRATION