Ntosake, September 2023 – Gamaliel Network

Prefix

Name(Required)

First Last

Pronouns

Email(Required)

Phone(Required)

Gamaliel Affiliation

Gamaliel Affiliate

Not a Gamaliel Affiliate

Gamaliel Affiliate(Required)

Organization Name(Required)

Emergency Contact Name(Required)

First Last

Emergency Contact Phone(Required)

Emergency Contact Email(Required)

Dietary Restrictions(Required)

Accessibility instructions/requests(Required)

Travel Plans(Required)

Until July 31, $500
August 1 – September 1, $600
September 2 – September 15, $650

Gamaliel Affiliate Ntosake 2023 Registration Fee(Required)

Price:

Non-Affiliate Ntosake 2023 Registration Fee(Required)

Price:

Commuter

I’m registering as a commuter

Commuters are not offered rooming, you will commute to and from daily.

Commuter Rate

Price:

Payment Options(Required)

Pay Now

Pay Later

Total

Billing Address(Required)

Street Address City State ZIP Code

Credit Card(Required)

Card Details

Cardholder Name