Test Registration Form Template – Womens Herbal Symposium

When

dates

Where

Black Oak Ranch
50350 Hwy 101
Laytonville, CA 95454

Contact

Terri Tall Tree & Gwen River Song
ncwhs@monitor.net
707-824-1429

Download the Work Exchange Application Automatically ~ Find it in your downloads folder

Download the Scholarship Application Automatically ~ Find it in your downloads folder

34th Annual
Northern California

Women's Herbal Symposium
ncwhs@monitor.net 707-824-1429

TEMPLATE FOR ALL SESSIONS

Welcome!

2024 TEMPLATE

Please fill out a separate registration form for each adult.

First Name

Last Name

Confirm Email

Phone/Mobile

Address

City

State

Zip Code

Select One

Skip this fee section if you have a code

REGULAR sliding scale 1

Fee: $490.00

Quantity

REGULAR sliding scale 2

Fee: $525.00

Quantity

REGULAR sliding scale 3

Fee: $525.00

Quantity

REGULAR sliding scale 4

Fee: $590.00

Quantity

CRONE discount age 60+, if needed sliding scale 1

Fee: $350.00

Quantity

CRONE discount age 60+, if needed sliding scale 2

Fee: $400.00

Quantity

Work Exchange ~ APPLICATION REQUIRED ~ link on left side bar

Fee: $150.00

Quantity

Scholarship ~ APPLICATION REQUIRED ~ link on left sidebar

Fee: $0.00

Quantity

Meal Choice

Regular Vegetarian

Vegan

Gluten Free

Vegan & Gluten Free

Do you plan to sell at the marketplace, your own handmade goods only? By donation, suggested donation 10% of sales.

Yes

List all marketplace items for sale, registrants own handmade goods only.

Ok to add you to the roster for the session that you attend?

Yes

Ok to add you to our general email list?

Yes

Interested in carpooling?
Check out the Ride Sharing link under the "general Info" button on the website.

Registering children or young women to attend with you?

Yes

In this section, please list the details for each child or young woman in your group.

Add One

Yes

First Name

Last Name of Registered Responsible Adult

Age of child: 0-11 or young woman: 12-21

Meal Choice

Regular Vegetarian

Vegan

Gluten Free

Vegan & Gluten Free

Add A Second

Yes

First Name

Last Name of Registered Responsible Adult

Age of child: 0-11 or young woman: 12-21

Meal Choice

Regular Vegetarian

Vegan

Gluten Free

Vegan & Gluten Free

Add A Third

Yes

First Name

Last Name of Registered Responsible Adult

Age of child: 0-11 or young woman: 12-21

Meal Choice

Regular Vegetarian

Vegan

Gluten Free

Vegan & Gluten Free

Add A Fourth

Yes

First Name

Last Name of Registered Responsible Adult

Age of child: 0-11 or young woman: 12-21

Meal Choice

Regular Vegetarian

Vegan

Gluten Free

Vegan & Gluten Free

Fees for Young Women and Children

I will choose from the fees below for all young women and/or children I have added.

Yes

Young Woman age 12-21, sliding scale 1

Fee: $175.00

Quantity

Young Woman age 12-21, sliding scale 2

Fee: $200.00

Quantity

Child age 3-11 years sliding scale 1

Fee: $60.00

Quantity

Child age 3-11 years sliding scale 2

Fee: $80.00

Quantity

Child age 3-11 years sliding scale 3

Fee: $100.00

Quantity

Infant, age 0-2 years, no fee

Fee: $0.00

Quantity

Young Woman age 12-21, Scholarship

Fee: $0.00

Quantity

Child age 3-11 years Scholarship

Fee: $0.00

Quantity

Proceedings of The Conference

This is our womyn's herbal words. This is a collection of hand-outs and articles from the classes of this session, bound together in a soft cover spiral-back book. Pick up your pre-ordered book when you check in on the first day. They will also be available for sale there for $25.00

Proceedings of the Symposium Book

Fee: $20.00

Quantity

________________________________________________________________________

No payment items has been selected yet

Checkout

Please enter your Total to calculate the credit card fee

Total

Pay with Credit Card

Select One to Checkout

Check or Money Order

Credit Card

Scholarship

I have a code

I understand that in order to keep my reservation I need to send in my check or money order within 5 days. If my fees are not postmarked within that time my reservation will be removed to make room for another participant. If I would like a payment plan I will contact Gwen within 5 days at: ncwhs@womensherbalsymposium.org.

yes

Make check payable to:
NCWHS
PO Box 28
Graton, CA 95444

APPLY CODE to receive full discount

Apply Code

Credit Card Fee

Cancellation Policy

If you cancel:

If you cancel before May 1st for the May Sessions and August 1st for September Session, we will refund your full registration minus a $25.00 processing fee. If you need to cancel after this date, you are welcome to find your own replacement and work out the finances directly with her.

There are no refunds, transfers or credits after these dates.

All requests for refunds must be in writing. Email is sufficient. No exceptions.

If we cancel:

NCWHS has full intentions of holding each Session rain or shine. However, in the event that we are forced to cancel before May 10th for the May sessions or before August 10th for the September session, we will refund as much of the registration fee as possible, to be determined at that time. If it becomes necessary for us to cancel after these dates we may be unable to refund any of the registration fee.

I have read and understand the Cancelation Policy

Refresh the page to register additional adults