Individual Registration

Please enter information in the form below to process registration for event Bears Ears Spring Break River Trip.

First Name *

Last Name *

Address

City

Zip

State

Phone

Email *

Special Accomodations

Emergency Contact Name & Phone *

How did you hear about this event? *

Social Media

Print Ad

Word of Mouth

Other

Participant's Tribal Affiliation

Parent or Guardian's Full Name *

Parent or Guardian's' Email Address *

Parent or Guardian's Phone Number *

I understand I, or my student, must complete the required digital forms by March 13th AND attend the mandatory orientation meeting on March 16th at 7pm, or my student's space on the trip will be offered to a student on the waitlist. *

Yes

Participant's school *

Individual Registration

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