Lyraccord in Concert Registration

Lyraccord in Concert

Phone

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

Contact Details

Name(Required)

First Last Pronouns

Email(Required)

Enter Email Confirm Email

How many tickets would you like to purchase?(Required)

Pricing(Required)

To use a BIPOC Spot, please select that option from the list, otherwise leave it on Sliding Scale.

Sliding Scale(Required)

$20 - 30. By offering a sliding scale, and two free BIPOC spots, 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 and scholarship spots. Please pay at the highest level that you are able.

BIPOC Registration

Price:

If you are using the BIPOC Registration code, then please select Venmo to pay, and you don't need to send any money unless you'd like to.

Payment Details

Total

How would you like to pay?(Required)

For prepayment we accept Venmo and Credit/Debit Cards. In person on the night of the event we also accept cash.

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

Address(Required)

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

Total

Credit Card(Required)

Lyraccord in Concert
Registration