2026 Pine Ridge Reservation Service-Learning Experience

2026 Pine Ridge Reservation Service-Learning Experience

Participant Registration Form
Work with Re-Member staff & volunteers to make life better for residents of the reservation, while learning about the culture and history of the Lakota people.

When: June 27 - July 3, 2026

Where: Pine Ridge Reservation, SD

Who: Anyone 14+

Cost: $800 trip fee + travel*

*We hope to reduce the cost through fundraising & donations. Scholarships are available.

Questions: Please contact Maggie Keeler - maggie@fcc-winchester.org
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

MonthDayYear
Date
Gender*
Re-Member bunkhouses provide separate sleeping quarters and shower/toilet facilities for males and females.
Are you planning on traveling with other family members?*
Youth under the age of 16 must be accompanied by an adult.
RE-MEMBER TRIP FEES AND PAYMENT POLICY

• The per-person program fee is $800, inclusive of a 4.2% state sales tax

Payments are due on date specified on invoice. For groups of two or more, payments are to be collected by the Group Leader and submitted via one check/credit card/ACH, rather than multiple checks from individual volunteers.

• FIRST PAYMENT of $320 (40% of total balance) is due within 14 days of trip invoice being generated.

• FINAL PAYMENT (60% of total balance) is due eight weeks prior to trip date. Trips booked less than eight weeks in advance will require payment in full within 14 days of the trip being invoiced.

CANCELLATION POLICY
Failure to pay an invoice and/or inform Re-Member of a cancellation or delay in submitting payment prior to due date may result in your group’s spots being released, a ban on booking future trips with Re-Member, and/or collection efforts.

For cancellations/reductions AFTER the first payment due date: There will be no refunds for cancellations/reductions, but the final payment balance will be recalculated to reflect the reduction in numbers.

For cancellations AFTER the final payment due date: There will be no refund or reduction in outstanding balance due.
The total per-person program fee is $800 (not including travel expenses). We hope to reduce this cost through the support of Outreach's Christmas Offering and fundraising.

Because we are limited to 14 volunteers, deposit of $320 is due at the time you register or no later than November 1, 2025. The deposit is non-refundable. However, if you cancel and we are able to find a replacement to fill your spot, we will issue a refund.

Please Venmo or submit a check payable to First Congregational Church with "Pine Ridge Trip" in the memo.

*Scholarships are available for both youth and adult participants. Please contact Maggie Keeler or Rev. Maeve Hammond if you would like to request a scholarship.

By signing below, you acknowledge that you have read, understood, and agree to the terms and conditions of the Re-Member payment policy, including your responsibility for all incurred charges and adherence to the payment schedule outlined herein. (If the volunteer is under the age of 18, a parent or legal guardian must sign this agreement.)
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