December 13, 2021 Moral March on Washington Partner Delegate Registration
Delegates:  
- must be fully-vaccinated for COVID-19 (you will be required to show proof after registration)
- are considering choosing to engage in nonviolent moral direct action
- are available to be in DC from Sunday, December 12th through Wednesday, December 15th
- have a valid ID

REGISTRATIONS ARE DUE BY 6PM ON MONDAY,  DECEMBER 6.
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Email *
State *
I am registering as a: *
Name of Organization sending you as a delegate *
Full name as it appears on your ID *
Birthdate *
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DD
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Delegate Phone Number *
Delegate Email Address *
Do you have any medical conditions that we should be aware of? *
For this event, are there any considerations we should know about that will ensure you can participate fully in this action? *
Required
Delegates must be fully vaccinated. Are you fully vaccinated against COVID-19 (and can show proof of vaccination)? *
Can you be in DC from Sunday, Dec. 12 through Wednesday, December 15? *
Emergency Contact Name *
Relationship to Emergency Contact *
Emergency Contact Email *
Emergency Contact Phone *
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