Tule Gathering
Name
First Name
Last Name
Roll Number
Email Address
example@example.com
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Would you like to be updated about the upcoming events?
Yes
No
What day will you be joining us harvesting?
7/17
7/18
Additional Participants - please provide name and age of any additional participants you will be registering for.
Photo and Media Release
Yes, I give permission for the Confederated Tribes of Siletz Indians (Healthy Traditions Program) to take and use photos or videos of me/my child during program activities for educational, promotional, and outreach purposes (including social media, newsletters, and websites).
No, I do not give permission.
Assumption of Risk & Liability Release: Participation in Healthy Traditions activities includes outdoor and hands-on experiences that carry inherent risks. By selecting "Yes," I acknowledge these risks and agree to participate voluntarily.
Yes, I understand and agree.
No, I do not agree.
Signature
Continue
Continue
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