Form Test Page – MorningSun

2023 BIPOC Retreat Registration

Plan to arrive at 5pm on Wednesday and to depart at 2pm on Sunday.

Your Name *

Email Address *

Phone Number *

Address *

Address

City

State/Province

Zip/Postal

Please list everyone you are registering (including yourself).

Full Name *

Age *

Physical Sex *

(for room assignment purposes, for example: "male, female, inter, or another")

Gender Identify As

(for example: "trans", "man", "woman", "non-binary", "cis", or another)

Preferred Pronouns

(For example: "she, her, hers", "they, them, theirs", or another)

Emergency Contact Full Name *

Emergency Contact Phone Number *

If you are human, leave this field blank.