Workshop Registration Form

FIRST, LET'S GET YOUR DETAILS...

**Please note that the name and email you register with will be what we use to register you for the Zoom meeting, send email reminders, and also how we will confirm registrants when they join in the Waiting Room on the day of. Please use the name you would like us to use to reference you.
* = required fields

First Name *

Last Name *

Email *

Confirm Email

*Please add us to your address book, hello[at]genderwheel.com, so you don't miss any emails! Gmail users make sure we're in the Primary tab.

Where are you joining us from? *

State / Province / Region

Country

I am registering as: *

Will you be joining the workshop as an individual or with others.
***Remember, 1 REGISTRATION = 1 SEAT in the workshop so if you are sharing with another please be sure that you ALL can attend from the same location and Zoom account on the day of the workshop(s), otherwise consider registering separately.

Registering as: *

Individual (1 registration)
2 People (1 registration)
Small Group of 5 or less people (1 registration)

What best describes you (check all that you feel comfortable sharing) *

Parent, Caregiver
Educator
Administrator
Therapist, Clinician, Social Worker
Librarian
LGBTQIA2S+
BIPOC
Other

if OTHER, feel free to elaborate here (OPTIONAL)

NEXT, A FEW MORE DETAILS...

* = required fields

Affinity Group(s) Selection: (check any and all preferences) *

What's This? Our workshops are designed for participant engagement. We like to offer the opportunity for folks to be in groups with others from their community during breakout sessions if desired. We will do our best to create affinity groups based on your choice(s), however the final groups will be dependent on who registers for the workshops. *Note that during the workshop you also always have the option to change groups.

Affinity Group(s) *

LGBTQIA2S+ Breakout Group
BIPOC Breakout Group
Mixed Breakout Group

How did you hear about these workshops: (check all that apply) *

How did you hear about these workshops? *

Mailing List
Instagram
Word of Mouth
Gender Wheel Website
Facebook
Other

if OTHER, feel free to elaborate here if you'd like (OPTIONAL):

Is there anything additional you'd like to share about your participation in our workshops (OPTIONAL)

FINALLY, SELECT YOUR SESSIONS & REGISTER...

* = required fields

What PART(s) would you like to Register for?

*Note that we strongly recommend PART 1 (or our Decolonizing Gender with Nature On Demand Video series) as a prerequisite for PARTS 2 and 3, but it is not required

PART 1: BACK TO NATURE - 3 Sessions; Wednesdays June 14, 21, 28 at 5-6:30PM PST (8-9:30PM EST) *

includes access to our Decolonizing Gender with Nature On Demand Video Series

-PART 1 REGISTRATION IS CLOSED-

PART 2: THE PLAYING WAY - 2 Sessions; Wednesdays, July 19, 26 at 5-6:30PM PST (8-9:30PM EST) *

PART 2

PART 3: POPBACK FOR PUSHBACK - 1 Session; Wednesday, August 9 at 5-6:30PM PST (8-9:30PM EST) *

PART 3

(OPTIONAL) Would you like to DONATE to our SCHOLARSHIP FUND?

TOTAL REGISTRATION FEES DUE:

360.00

Review our Cancellation Policy *

I have closely reviewed the ONLINE workshop dates and times above. Since these workshops have limited "seating," I understand that there are no refunds once I register. By submitting my registration and payment I confirm that I understand this cancellation policy.

Pay Securely with a Credit Card:

Processed via Stripe (we do not store any credit card information on our website)

ALMOST DONE!

Clicking the "Submit Registration" button below will send us your registration and finalize your credit card payment.

***YOU HAVE NOTE REGISTERED FOR ANY SESSIONS.

Please review your selections above.

The Gender Wheel

We're excited to be in community with you!

REGISTRATION FORM

Gender Wheel® 101 Workshop Series