*a WALK-IN Purchase

* These fields are required

1 Welcome

2 Choose your accommodation

4 Optional Items

2024 Adult dinner

CAD $37.00

Select quantity

2024 Adult lunch

CAD $26.00

Select quantity

2024 Adult breakfast

CAD $19.00

Select quantity

2024 Adult meal package

CAD $75.00

Select quantity

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5 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.
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.
Phone - work	Work or office phone, if we need to reach you about your registration.
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?
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 ____.
Is there anything else you'd like to tell us?	Please provide any other information that you would like us to consider when processing your registration request. If you would prefer to speak directly with a Registrar please email register@haven.ca
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.

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6 Donate to The Haven

CAD $	Help others to attend Donate to The Haven Financial Aid Fund. The Haven is a federally registered educational charity in Canada and the United States.

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

50% Deposit	$0

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 Additional Programs

Participants

4 Optional Items

5 Tell us more about you

6 Donate to The Haven

7 Payment