Family Education Workshop & Early Drug and Alcohol Recovery Groups Payment

Education and ERG Program Payments

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I would like to attend the*

Family Education Workshop

Family Early Recovery Group

Early Recovery Group (former guests)

Family Education Workshop $150 per person

Price: $150.00

Family Early Recovery Group - 1 week $25 or 12 weeks $300

This program is intended for family and friends who have completed the 4 day Family program.

1 Week - $25

12 Weeks - $300

Family ERG - Other Amount

Number of Weeks for "other amount".

Early Recovery Group - one week $25 or 12 weeks $300

This is a virtual program intended for individuals who have recently completed treatment.

1 Week - $25

12 Weeks - $300

ERG - Other Amount

Number of Weeks for "other amount".

Name of family member attending Family ERG*

First Last

Name of family member or friend in treatment

First Last

Name of family member or friend in treatment (optional if applicable)

First Last

Payment Information

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Terms and Conditions*

Family Education Workshop and Early Recovery Group payments are non-refundable.

I understand

Total

Credit Card

Card Details

Cardholder Name

Phone

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