2022 Autumn Convergence Registration Form
Greetings!

Please take a few minutes to fill out this registration form.  

YOU MUST CLICK "SUBMIT" at the end of the form.  

When submitted, you will immediately receive an automated on-line message confirming submission  

An email, FROM GOOGLE, containing the information you entered will be sent to the email address you provide.  

Within a few days, you will either receive an INVOICE via email from New Culture Northern California with a DUE DATE for payment, or you will receive notification that you are on our waitlist.  If you receive an invoice and need to arrange a staggered payment plan, please email us.  

The email address you provide in this form will be used for all communications.  Please PROVIDE AN EMAIL ADDRESS YOU CHECK OFTEN.  If this is a hardship for you, please provide details and options for communication in the 'Additional Comments or Questions' section at the end of the form.

Please fill out one form per person.   Contact us by email if you need to make changes after submission.

Autumn Convergence EMAIL ADDRESS: newculturenorcal@gmail.com

We look forward to your participation in Autumn Convergence!

If you have not already reviewed the NCNC website (www.newculturenorcal.org), please do so before completing this form.  You may want to have it up in another window for reference while completing this form.

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Email *
First Name *
Last Name *
Primary Phone *
Please provide at least one phone number.
Other Phone (only if this is important to you)
Street address (optional)
City *
State *
Optional note for the contact list
For example - "Leave a voice-mail' or "Prefer text".  You'll have another chance to edit contact info you wish to share, or not share, during on-site check-in.
May we publish your name, city/state, phone number and email to other registrants to assist with ride-sharing? *
Food Allergies and Dietary Preferences *
Please list food allergies. Separately, please list any foods you want to avoid.  If no allergies or preferences, enter "none". Saratoga Springs will do their best to accommodate preferences, and a Personal Foods Kitchen will be available for you to store and prepare any unique dietary requirements Saratoga Springs cannot accommodate.  
Meat Option - I wish to be contacted if a meat option is offered, for an additional fee, so I may opt in or out.  Standard menu is Vegan and Vegetarian Friendly. *
Lodging *
Please let us know your lodging plans. Please CHECK AVAILABILITY on the Lodging page of the website before choosing a Cabin Room.
If you are sharing a room reserved by someone else, who reserved the room?
SKIP THIS QUESTION -
Clear selection
Do you need electricity for a medical device? (No fee for this, but your location options will be limited and you will need to provide your own extension cord.) *
If staying in a Shared Dorm Room, please tell us if you snore, use a CPAP, wish to occupy and agree to a quiet room, or have other circumstances we need to know about.  
If planning to use an RV/Vehicle camping space, please describe your set-up (size, any special needs, etc.).  Limited RV Electric connections are available for $25 per day paid to Saratoga Springs.  If you wish to reserve a space with access to RV Electric, please include in your answer.
When do you plan to arrive? *
We ask that everyone arrive in time to be set-up in time to be present for Opening at 4 pm, 9/16.    
Required
What time are you planning to arrive? *
If you are participating in Early Arrival, would you like to purchase any of the following meals (fee will be included in your invoice).
I have reviewed the range of registration fee (currently $1,000 - $2,000) and determined my fee to be as stated below.  This is ONLY registration for September 16-21. Do not include amounts for any other fees - they will be added to your invoice.  $1,000 is the minimum amount.  If you are seeking financial assistance with the minimum amount, please provide that information in the Additional Comments and Questions section below, and enter $1,000 here. *
Please fill in amount WITHOUT a dollar ($) sign. Thank you!
I would like to make a contribution to the scholarship fund.
Please fill in amount WITHOUT a dollar ($) sign. Thank you!
I want to sponsor a portion of someone's registration fee.
Clear selection
Amount of sponsorship(s) offered, and to whom?  (Requests for sponsorship are shown on the website.)
If you did not attend this event at Saratoga Springs in 2017, 2018 or 2019, please tell us which New Culture camps/events you've attended.  If none, please tell us a little about yourself, how you found out about this event, why you want to attend, and what you plan to contribute. This event is created for those experienced in the New Culture Community.  If we do not know you have this experience, we will reach out to you to chat about the event and if it is a good fit for you. The event is led by volunteers and is not staffed to provide extensive orientation or in-depth integration.  We 'dive deep' quickly.
I have read the Informed Consent document on the event website (the link is just above this form on the webpage) and I agree.  I understand that my participation in Autumn Convergence is dependent upon my agreement with the document or to reach a mutually acceptable agreement with the Wisdom Team after I initiate a conversation shortly after my registration.  Also, a liability waiver must be signed upon arrival at Saratoga Springs. *
Please let us know your pronouns.
Additional Comments or Questions (anything you wish to communicate that wasn't covered previously)
A copy of your responses will be emailed to the address you provided.
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