Artist Residencies Registration & Payment

This registration is for folks who have already applied and been accepted. See more info here.

We’re excited to Welcome you to WildHeart. This is the last step in the process, so we have the basic info we need, and you can submit your payment!

"*" indicates required fields

Name

This field is for validation purposes and should be left unchanged.

Name*

First Last Pronouns

Email*

Enter Email Confirm Email

Phone*

How did you hear about us?

What brings you here?

e.g. a particular program or event? visiting a friend? (If so, who?)

Number of Guests:*

Additional Guest Names*

Check-in Date*

Check-out Date*

Number of Nights

Housing Payment Sliding Scale (per day/guest)*

Please enter a number from 50 to 125.

Please enter the per-day rate you would like to pay. By offering a sliding scale of $50-$125 per person per night, we hope to make this offering financially accessible. Paying at the higher end of the sliding scale MAKES IT POSSIBLE for us to offer a sliding scale. Please pay at the highest level that you are able.

Housing Cost

This is calculated from the number of nights, times the daily sliding scale rate chosen, times the number of guests.

Join the Wildheart communal food system while you're here?

Will you be joining the WildHeart communal food system while you're here? (ie buying into shared groceries)

Yes please

No thanks

I'm not sure yet.

Payment Amount Towards Food:*

This amount is calculated as $20 per day per guest for food.

Food!

We work to provide nourishing, ethically sourced food to meet a wide range of dietary restrictions and preferences. There is always fridge and pantry space available for any personal items you choose to bring with you, but please tell us what food helps you thrive, and any foods you avoid.

How do you plan to travel to WildHeart?*

Access = Love. Is there anything about your physical or mental condition that might impact your stay at WildHeart? If so, what support can we provide?

Is there anything else you'd like us to know about your stay?

Emergency Contact:

Emergency Contact's Name*

First Last

their email*

and phone number*

...relationship to you:*

Total for Your Stay

Price: $0.00

How would you like to pay?*

We accept venmo and card for registration.

Please send your payment to @WildHeartCenter when submitting this form.

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card

Total

After clicking "Submit" below, you will be redirected to payment options.