Gathering 2023 Registration Form

1
Name* This field is required.
First Name
Last Name
2
Tribal Affiliation
3
Email
example@example.com
4
Are you attending as a member of staff for a tribal nation?
YESNO
5
Would you like to receive email updates about the 2023 Gathering?
YESNO
6
Phone Number
Please enter a valid phone number.
7
Would you like to receive text updates about the 2023 Gathering?
YESNO
8
Add in your T-Shirt Size:
9
Do you have Tribal Youth attending with you? Add in their information below: Name, T-shirt size, Age Please make sure to indicate youth
Huge
Large
Normal
Small
Ok
Ok
10
Do you have any non-tribal family members traveling with you? Please add their first and last names
Huge
Large
Normal
Small
Ok
Ok
11
Photo Release Form: I hereby grant the Nottawaseppi Huron Band of the Potawatomi permission to use my likeness in a photograph or video in any and all of its publications, including website entries, without payment or any other consideration. I understand and agree that these materials will become the property of the Nottawaseppi Huron Band of the Potawatomi and will not be returned. I hereby irrevocably authorize the Nottawaseppi Huron Band of the Potawatomi to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicizing the Nottawaseppi Huron Band of the Potawatomi programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph or video. I hereby hold harmless and release and forever discharge the Nottawaseppi Huron Band of the Potawatomi from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may by reason of this authorization.
Clear
12
Which days will your group be attending the Gathering?
Day 1
Day 2
Day 3
Day 4
Day 5
Day 6
All Days
13
Will you or others in your group be attending the Language Conference taking place July 24 & 25? Enter their names below:
14
Will you or others in your group be attending the Youth Conference taking place July 24-26? Open to ages 10-17. Enter their names below:
Should be Empty: