Getting The Love You Want: Registration

Your Name (required)

Partner's Name (required)

Street Address (required)

City (required)

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Zip Code (required)

Phone (required)

Alternate Phone

Your Email (required)

Enter Location and Date of the workshop you are registering to attend. (required)

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Authorization (required)
I Agree to and understand the cancellation policy and if paying by PayPal would like to send payment now.

Manuals and food are ordered, and space is rented based on number of couples signed up weeks in advance. Therefore, cancellations are costly, and because of this, the following stipulations apply:

  • If you cancel with less than two weeks notice, you can apply the entire fee toward a future workshop.
  • If you cancel with more than two weeks notice, you will receive a refund minus $100 for admin expense.

Thank you for your understanding and cooperation.

Please note: Registration is a two step process. First is to submit this form. Next is payment either manually by check, credit card or via PayPal online.

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Jeannie Ingram specializes in Couples and Marriage Counseling, Imago Relationship Therapy, Individual Therapy, and Coaching. 

© Jeannie Ingram - Nashville

4525 Harding Pike, Suite 200, Nashville, TN 37205

404.444.1058 

ingram.jeannie@gmail.com

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