Test

ATTENDEE
Enter Full Name for Nametag*
First Name Last Name

City where you live*
Email*

Phone*
Dietary Restrictions, if any
Date of Your Loss (Leave blank if not a widow)
MM
DD
YYYY
Age Category
Is this your first Widow Might Event?

Yes

No
Add any additional attendees and their information.
TOTAL AMOUNT FOR ALL ATTENDEES
Payer Email*
Tickets Quantity*
Price: $38.00
Tickets - Recent Loss Quantity
Price: $28.50
Optional Donation Amount ($):
Total
$0.00
Indicate your Widow Connect group
Comments or Questions
When you click on SUBMIT you will be redirected to Stripe where you will be asked to enter your Debit or Credit Card information to complete your payment and registration.
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ATTENDEE