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Gathering Registration Form

To register for the upcoming Gatherings please complete the form below. When you are finished, click submit. On the next page you'll be able to print your registration form and fill in your payment information. Please mail completed registration forms and payment information to FHC at the address listed on the bottom of the form. Payment must be received by within 7 - 10 days to be officially registered for the Gathering. You will be mailed a receipt once payment is received.

If you have already registered, please DO NOT register again.  If you need to change your registration information please contact Monica Rowland at 727-873-2005.

* Indicates a required field.
Complete Name of Person Registering:
*First and Last Name:  
This will become your user name and will be required on  the next page.
 

Person One:
*First Name:
*Last Name:
*Name to be used on name tag:
*E-mail address:
*E-mail type:
  Please enter an e-mail address to facilitate correspondence regarding your Gathering trip. Your e-mail address will not be shared with third parties.
*Home address:
*City:
*State:
*Zip:
*Home phone:
Business phone:
Cell phone:
 

Person to contact in case of emergency:
*Contact Name:
*Contact's relationship:
*Contact's Phone Number:
 

Special Needs:
Please list any special needs, including dietary restrictions:
 

Person One what Gathering are you registering for:

 

Person One Gathering activities your registering for:
Everglades
Friday Pre-Gathering:
Nature Writing Workshop $50
 Gathering: $300
 

Please note:
 All Gathering participants must be members of the Florida Humanities Council. An annual FHC membership is valid for all individuals residing in the same household. If you are not a current member of the Florida Humanities Council, please select “no” below and an additional $50 FHC annual membership fee will be applied to your final total.

I am a current FHC Member:

  YES NO

Person Two

Contact Information:
First Name:
Last Name:
Name to be used on name tag:
E-mail address:
E-mail type:
  Please enter an e-mail address to facilitate correspondence regarding your Gathering trip. Your e-mail address will not be shared with third parties.
Home address:
City:
State:
Zip:
Home phone:
Business phone:
Cell phone:
 

Person to contact in case of emergency:
Contact Name:
Contact's relationship:
Contact's Phone Number:
 

Special Needs:
Please list any special needs, including dietary restrictions:
 

Person Two what Gathering are you registering for:

 

Person Two what activities you are registering for:
Everglades
Friday Pre-Gathering:
Nature Writing Workshop $50
 Gathering: $300
 

Please note:
 All Gathering participants must be members of the Florida Humanities Council. An annual FHC membership is valid for all individuals residing in the same household. If you are not a current member of the Florida Humanities Council, please select “no” below and an additional $50 FHC annual membership fee will be applied to your final total.

I am a current FHC Member:

YES NO