One Day Event Registration Form 261101

Sunday, November 1, 2026 - 9am to 4:30pm

CYO Retreat Center, Occidental, California

Early Bird Registration (by October 21, 2026) using this form is $110. Registration after October 21 or at the door is $140 (at the door payable by cash or check only - sorry, no credit cards at the door.) Lunch will be provided, and ALL PROCEEDS WILL GO TO THE SCHOLARSHIP FUND FOR THE ANNUAL CONFERENCE.*

A limited number of partial Scholarships to this event are available to men unable to afford the full Registration Fee. IMPORTANT: Those who wish to attend this event under a Scholarship MUST contact our Registrar, Conrad Larkin, (call 707-566-7570 or text to 707-478-3228) to make special Scholarship arrangements and acquire a Discount Coupon Code before filling out this Registration form. Once you have a Code, return here to fill out the form, select a Registration Type and apply the Discount Coupon at the bottom of this form.

*This is the primary fund raising event for the Scholarship Fund. Please consider selecting the Regular Registration Plus option below, which will give an extra $25 directly to the Scholarship Fund. Thank you!

Name

First NameLast Name

Email

Confirmation Emailexample@example.com

Phone Number (Cell phone preferred)

This is in case we have a question.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Have you attended a Redwood Men's Center event previously?

How did you hear about this Event?

Maintain your connection following the Conference by joining our invitation-only Discussion Group (RMC_Conference)

Birth year only (NOT the whole date)

Just your 4-digit birth year, please (NOT the whole date.) We need this to help in planning the event. It is not used for any other purpose and is not shared or distributed in any way.

Additional information/requests/comments?

Please verify that you are human

Select Registration Type (select one only). NOTE: Scholarship attendees will need to contact our Registrar for a Discount Coupon Code BEFORE filling out this form. See top of form for contact information.

Early Bird Registration (must register by October 21, 2026)

Includes lunch. Must register and pay by October 21, 2026

$110.00

Regular Registration (received after October 21)

Includes lunch. Registration received after October 21, 2026, paid online

$140.00

Pay $140 at the door, cash or check only.

Includes lunch. Sorry, no credit cards if paying at the door.

Free

* Regular Registration PLUS (Choose this any time)

I want to give something extra. Full registration including lunch, plus an extra $25 for the Scholarship Fund.

$165.00

Enter coupon

Total

A One Day Redwood Men’s Center Event

Select Registration Type (select one only). NOTE: Scholarship attendees will need to contact our Registrar for a Discount Coupon Code BEFORE filling out this form. See top of form for contact information.

Pay with Credit Card