Permaculture Design Certificate (PDC) Registration 2019
Registration form for the Permaculture Design Certificate (PDC) full program or individual modules
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Please complete this registration to confirm your participation in the full Permaculture Design Certificate Program or any of its individual modules.  Once your registration has been processed, we will contact you with additional information. If you have any questions about the program or registration, contact us by email at thedeaneryproject@gmail.com or by phone at 902-845-1888.
Registration for the 2019 Permaculture Design Certificate full program or individual modules
Select Full PDC OR any individual module(s) *
Required
Personal Details
This information will  be used only for administrative purposes and in case of emergency.  
Full Name *
What you prefer to be called
Preferred pronouns
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Address *
Phone Number (main) *
Phone Number (alternate)
Email *
Please identify any dietary restrictions or requirements
Do you wish to be added to the Deanery Email list?  NOTE: We send email about once every two months and do not sell or share our contact list. *
Required
How did you hear about this course?
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Emergency Contact Information
This information will only be used for administrative purposes and in case of emergency.
Full Name *
Clear selection
Phone Number (main) *
Email *
Relationship to participant *
Health
Information that would be required in case of accident or illness.
Allergies, Medications/Medical Issues or any other information that could impact your ability to participate in program activities *
Health Insurance Information
Each registrant is responsible for all medical expenses incurred during or arising from a Deanery Program and, if not a holder of a provincial health card, should be covered by his/her own health insurance policy.
Health Card # *
Expiry *
Province *
Private Insurance Company Name
Policy #
Is pre-authorization required for treatment?
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Pre-authorization phone # (if required)
Family Physician *
Physician Phone #
Accommodations
Registration fees include meals and dormitory or camping accommodation (subject to availability).  Participants are responsible for any offsite accommodation requirements.
What accommodation type will you use? *
Payment Options
There are a limited number of work-trade arrangements available.  
In addition, we can arrange payment plans on an individual basis.
For more information on either of these options, contact Kim at 902-845-1888

NOTE: There will be an additional charge added if you choose to pay with credit/debit through EventBrite
How do you plan to pay?
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Natural Products Policy
To provide a safe space for those with environmental sensitivities WE ARE A SCENT FREE ENVIRONMENT.  If you have questions on this,  please contact us at thedeaneryproject@gmail.com    Thank you!
Thank you.  Click SEND to submit your registration.  
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