Scholarship Recipient Registration

Woman's Journey Dec 4-6, 2026

A New Freedom & A New Happiness Awaits

Complete this form and click Register to complete the remaining payment and reserve your spot.

*First name

*Last name

*Email

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

*Recovery Program

Al-Anon

List dietary restrictions here:

List required mobility accommodations:

Select Desired Lodging

Manor House

Pheasant Run

Wynne/Flato Lodge

Select Floor

First Floor

Second Floor

Enter Desired Room Number (if known)

Preferred Roommate (List up to three). Note: We will do our very best to honor your request. If you leave it blank, we will thoughtfully select your roommate for you.

List roommate choice #2

List roommate choice #3

*Select your top three service preferences. (Note "*" indicate highly needed)

* Friday Set-Up Crew

* Sunday Pack-Up Crew

Afternoon Experiential Activity Leader

Candlelight Meeting Chair

Golf Cart Driver

Hospitality

Workshop Leader

Event Photography

Fireside Meeting Chair

Raffle Assistant (During Event)

Raffle Donations (Before Event)

Registration & Check-In

Meditation Activity Leader

Yoga Activity Leader

*Payment Options ~ Select One

Scholarship Registration - Required Contribution and credit card fees.$77.55

Scholarship Registration - Required Contribution. I will not cover fees.$75

Optional Additional Donation to Support Woman's Journey

$10

$20

$30

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