Western Region Fall Gathering 2017 – Adult Registration Posted on July 11, 2017 by Vyda Ng Western Region Fall Gathering 2017 - Adult Registration "Envision - Engage - Energize" Name* First Last Preferred name on nametag Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Email* Enter Email Confirm Email Phone*CongregationPlease check where applicable I would like to join the CUC's mailing list for news and events I am currently on the CUC's mailing list for news and events I can't remember. Please add me to the CUC's mailing list for news and events Please do not add me to / remove me from the CUC's mailing list for news and events RegistrationFor Young Adults (18-35)Hello young adults! If you are 18-35 and are registering for the Western Region Gathering, please let us know a bit more about your participation: I plan to participate in Friday and Saturday evening young adult social events I would like to have home hospitality over the weekend Please sign me up for the CUC Young Adults newsletter (4-6 emails/year) - Young adults 18–35 may apply for subsidy – forms available at cuc.ca/subsidies/ Western Region Fall Gathering Registration*Early Bird - Full Gathering (until Sep 15) - $135.00Regular - Full Gathering (Sep 15 - 29) - $160.00Students/ Young Adults/ Self-defined low income - Full Gathering - $60Saturday only - Truth, Healing & Reconciliation - $90.00Saturday only - Truth, Healing & Reconciliation Students / Self-defined Low-income - $50.00Registration for FULL WEEKEND includes materials, Saturday lunch and dinner, and Sunday lunch. Registration for SATURDAY ONLY includes lunch. *Accommodation not includedProgramAll activities occur at the Unitarian Church of Calgary, 1703 1 St NW, except the Adult and Childrens’ Programs on Saturday from 9 am to 3:30 pm, which are held at Wild Rose United Church, 1317 1 St NW. Friday, 5:30 pm at Unitarian Church of Calgary - Registration, Welcome and Reception. Saturday, Wild Rose United Church - 9:00 am start with Ingathering and singing, followed by keynote address, morning & afternoon sessions. Saturday: 4 pm, Unitarian Church of Calgary - Blanket Exercise, Dinner & Entertainment Night. Sunday, 9 am - Networking, Worship & Lunch Please let us know the events you plan to attend to help us predict numbers. Please note that all Saturday workshops include the KAIROS Blanket Exercise from 4-6 pm at Unitarian Church of Calgary, & Workshop E - Truth, Healing & Reconciliation - runs all day).* Friday Multigenerational Welcome and Reception Saturday Keynote with Dr. John Pentland Morning Workshop A - More Fishing Tips Morning Workshop B - "Pick a Pack of Posies" Creative Art Session Afternoon Workshop C - Congregational Visibility & Welcoming Young Adults Afternoon Workshop D - Singing for Change All-Day Workshop E - Truth, Healing & Reconciliation Saturday evening Entertainment Night hosted by Jane Perry & Tony Turner Sunday Worship Click here for more information about the scheduleSunday Networking Sessions*Session 1: An Invitation to a Conversation with CUC Board MembersSession 2: Refugee Sponsorship GroupsSession 3: Fundraising - You Are Not AloneI am not attending a networking sessionClick here for a description of the networking sessions.Accommodations*Accommodations are not included with registration. Special rates for Western Regional Gathering participants are available at the Southern Alberta Institute of Technology (SAIT- 1301, 16th Ave NW). Only two bedroom suites are available for the following prices. $115/night + 9% tax for the whole suite $57.50/person for a bedroom If two people are sharing a bedroom, there is an additional $10 charge/night Room price includes breakfast and parking. SAIT is 5 minute drive or 1.9 km. from Unitarian Church of Calgary.Yes, I would like to book accommodations at SAITNo, I do not need accommodations at SAITBilleting - is limited and available on a best-efforts basis* Yes, I would like to be billeted. No, I do not require billeting How many people?How many beds?Pets/pet allergies?Food allergies?Need transportation?TransportationThe Calgary host team is offering some assistance with transportation. Please indicate below if you would like transportation. The transportation coordinator can be contacted at email@example.com.Transportation*Yes, I need transportation to lodging and/or program sitesNo, I will make my own wayHow many seats do you need?Please check all that apply All areas of Wild Rose United Church and Unitarian Church of Calgary are wheelchair accessible.I use a : wheelchair motorized scooter walker / cane MealsPlease indicate your dietary preference, & which meals you will be attending.My dietary preference:*OmnivoreVegetarianVeganSevere food allergies (attempts will be made to accommodate severe allergies but are not guaranteed. Food may come into contact with nuts, seafood, and other food allergens)I will be at the following meals:* Saturday lunch Saturday dinner Sunday lunch Payment DetailsWe would like to offer bursaries to support those who might not otherwise be able to attend.Click to add donation for limited income YES, I would like to donate so that a person with limited income can attend the gathering. Donation amount for limited income I am also including a donation for:Please select fund: Friends of the CUC Fund E.B. Ratcliff Leadership Development Fund Supporting the Dawning Future Youth and Young Adult Subsidy Fund Click here for more information on each fund. Friends of the CUC Fund donation amount: E.B. Ratcliffe Leadership Dev. Fund donation amount: Supporting the Dawning Future Y & YA Subsidy Fund donation amount: Total $ 0.00 CAD Method of Payment:*PayPalCredit Card by phoneYou do not need a PayPal account to pay online - choose the "Pay with a credit or VISA debit card" option on the PayPal page. If you are paying with credit card by phone, please call the CUC office at 1-888-568-5723.LegalPhoto and Video ReleaseThe Canadian Unitarian Council and the Unitarian Church of Calgary may take photographs and some video at the Regional Fall Gathering and may use them in CUC news or promotional materials whether in print, electronic format or other media, including the CUC’s website. Please check the appropriate box below* I AGREE. I give permission for my name, photo or video images to be used by the CUC on its website, in print, electronic or other format. I DO NOT agree. I do not give permission for my name, photo or video images to be used by the CUC on its website, in print, electronic or other format. Terms:Conference Fee The registration fee does not include accommodation, travel or any other expenses that may be incurred by attendees. Payment Terms Registration fees are due and payable at the time of registration. If you are paying with credit card by phone, you are not considered registered until full payment is received. Cancellation and Refund Policy All requests for refunds must be submitted to the Financial Administrator, by e-mail (firstname.lastname@example.org) or Phone (416-489-4121). Requests for refunds receive a full refund less a 15% administrative fee per person. No refunds will be made for cancellations received after online registration is closed or for no-shows. Your Contact Information Information provided to the CUC through the event registration form may be used to contact you with further details on this event when necessary and is added to the CUC database in order to send you notices from time to time. Your full name and contact information is only shared with other attendees if that option is selected during the online registration process. Your contact information will never be shared with third party organizations or companies. Right to Refuse Admission CUC reserves the right to refuse admission, by refunding the fee, or, a proportionate amount if admission is refused partway through the Conference. General Program information distributed prior to the conference is subject to change. It is agreed that the Canadian Unitarian Council, its employees, officers, volunteers, contracted staff and agents shall not be held liable or responsible for any loss, injury or damages, however caused, to any person engaged by participating or attending the Western Region Fall Gathering. It is agreed that the Canadian Unitarian Council, its employees, agents and officers reserve the right to refuse admission, cancel or reschedule programs, change speakers, locations, or revise content. Agreement* I agree to the above terms.