Teens Alive 2

Book now and get CAD $60.00 off regular price. Remaining balance due on or before Jul 21, 2025 to qualify for CAD $60.00 off regular price. This offer valid until Jul 21, 2025.

* These fields are required

1 Welcome

2 Choose your accommodation

3 People in your group

Guest 1		First Name* Last Name* Email* Gender
Guest 1		First Name* Last Name* Email* Gender

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5 Optional Items

6 Tell us more about you

Preferred name	Different than first name, what you are called or the name you go by. If you're joining us online, it's helpful if your registration matches your name on Zoom.
Pronouns	We invite you to share your pronouns with us during registration and again during the program. You can add your pronouns to you Zoom name.
Phone - cell	Cell or mobile phone. Please note that your email and phone number may be shared with the program leaders. View terms and conditions for more details.
Address	This is where we will mail any tax receipts.
Address 2
City
State/Prov.
Zip/Postal
Country
Gender
Birth Date *	A participant must be 19 or older to register for an adult program at The Haven
Diet Notes	Regular (includes meat option when available) Vegan Vegetarian Pescatarian Gluten Free Dairy Free Medically severe allergy The meal package includes either a regular or vegetarian/pescatarian option. Other special requests (gluten free, vegan, dairy free) will be accommodated at an extra charge of $5/day.
Additional dietary info	Is there any particular meat or other food you don't eat? Anything else we should know about your food preferences?
Medical Information	medications, surgeries, current issues.
Additional rooming information	Examples: request a specific roommate, no stairs, etc.
Emergency contact	Who should we contact in the event of a personal emergency? Please choose someone who will be available during the program.
Emergency contact phone	Phone for your emergency contact.
Emergency contact relationship	This person is my ____.
Terms and Conditions *	I accept the terms and conditions.View terms and conditions. Some online program sessions may be recorded. Audio and visual of participants will not be shared without prior consent.
Email communications	Yes, I agree to receive additional resources, special offers, and occasional updates related to opportunities at The Haven.As part of your program registration, you will receive a few essential emails from us related to your experience. Beyond that, we hope you'll opt in to stay connected. You can unsubscribe at any time.
How did you hear about this program? *	The program leader's website, email, or social media Email from The Haven The Haven's Social Media A friend or family member The Haven's Website During another Haven program Doctor, counsellor or medical professional alive magazine article Please check all that apply and provide the name of the person referring you if this applies.

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7 Payment

Autofill will update info above!
If you are registering someone other than the cardholder, please enter credit card number manually.

Sub Total	$0

Taxes	$0

Deposit	$0

Pay	Choose to pay a deposit or the full amount right now.

Due Now	$0 $0

Choose Payment Option

	Interac eTransfer - to accounts@haven.ca Read more about Interac e-Transfer. Click on the button below and these instructions will be repeated on the next page.

First Name
Last Name
Card Type
Card Number *
Card Expiration *	Month Year
Card Security Code	usually a 3 digit code on back of card

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1 Welcome

2 Choose your accommodation

3 People in your group

4 Additional Programs

Participants

5 Optional Items

6 Tell us more about you

7 Payment