OVERVIEW

 
 
The NC Climate Justice Summit (NCCJS) is a statewide gathering of youth and adult community leaders working together to create socially just solutions for the climate crisis.
 

 
 
 
 

GROUP REGISTRATION FORM

By completing the registration form below, you are confirming your participation in the fourth annual North Carolina Climate Justice Summit (NCCJS).  Your registration is not complete until your fee is processed.  The group leader will use this form to register all of the participants and Group Leader for the group.  The required information must be entered for each registrant. Only one payment type is accepted per registration.  The entire group payment must be received by October 31st in order to guarantee a space/spaces for the Summit. 

 

LODGING & MEALS

On-site lodging is available for NCCJS participants. Groups with their group leader/chaperones will be housed in cabins which can each accommodate 9 persons.  One adult per 8 youth, who is the group leader or another Adult accompanying the group must stay in the cabin and chaperone their youth.  Example - 16 youth would require 2 cabins and 2 Adults. All meals are included with your lodging. If there are additional  adults accompanying the group that would like to stay in the lodge rooms, please click this link and register using the Adult Registration Form.

 

REGISTRATION FEE

The registration fee for Group participants, Youth (under 18) and their group leader/chaperone is $50 per registrant.  There is no additional cost for the cabin. The fee includes all NCCJS programming and materials. This fee is required for ALL attendees, including those who stay offsite. 

 
 
THANK YOU!!  We look forward to seeing you in November!
 
NCCJS Leadership Team
 


November 17, 2017 4:00pm - November 19, 2017 3:00pm
November 3, 2017 11:00pm [Eastern Time]
Haw River State Park
339 Conference Center Drive
Brown Summit, NC 27214
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INFO:   Please note that this form contains limited capacity items which are sold out. They are displayed grayed out and/or are not selectable. You may choose alternate options or join the waiting list.

INFO:   Please note: The registrant fields preceded with a gray bullet point are semi-required. If you do not have this information or choose not to enter it then the registrant will be informed via email and asked to complete their registration.

Group  

Participant
Leadership Team Member
Sponsor
Volunteer
Workshop Presenter
Intern
Impacted/frontline community member


Review Your Payment Information:

Registrant Fee: $0.00



Billing information


Billing and Payment
Billing and payment processing for Businesses' events is performed by Member Solutions, Inc. ("MSI"), and this contract is specifically assigned to MSI for all such purposes. Customer knowingly and irrevocably authorizes MSI to charge electronically Customer's bank account and/or credit card for any and all amounts due for Customer's, and anyone registering under Customer's, attendance and participation in the Event. Please note, you may see all or any portion of the following on your bank or credit card statement: "MSI*NCCLIMATEJUSTICESUMM 8882448044 ONLINE REG FEE". Any returned payment will be assessed a $25.00 fee. Any unsuccessful electronic transaction is subject to a $10.00 processing fee. MSI is not responsible for any bank fees incurred by Customer. MSI has the sole right to resubmit returned or declined items (plus applicable fees) without prior notice. BILLING INQUIRIES -- 888-244-8044 or by mail to PO Box 297, Hatboro, PA 19040.

Applicant Agreement
I represent that I am the person who appears on the application above. I acknowledge and agree to the statements, terms and conditions above, as well as any applicable terms and conditions for this registration, and that by typing my name below and completing this registration form, I am electronically signing the document, which will have the same legal effect as the execution of the document by a written signature and shall be valid evidence of my intent and agreement to be bound.

Applicant Signature
Please enter your full name in the space below.
 


Please click the button below to finalize your registration.



Registration inquiries:
Leadership Team
info@ncclimatejustice.org
PO Box 15422
Durham, NC
27704 USA
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Please complete the following information for each ADULT and YOUTH registrant. Make sure to make the proper selection for each individual before completing the information for registering. As you complete each person, please choose "add another registrant".  Once completed, only ONE payment is accepted for the entire registration, 

The following three questions will help us ensure that the Summit includes a diverse mix of participants:

The Following questions will assist us with event preparation:

FOOD - Meals are included in your registration fees.  Please indicate your dietary restrictions.  Include any food allergies in the included field.  We will do our very best to meet all dietary needs/restrictions. Multiple boxes may be checked for this question.
 

No Restrictions
Vegetarian
Vegan
Gluten Free
Dairy Free
No Peanuts
Please describe any food allergies below:
 

 
POLICIES/PROCEDURES
 
Arrival/Registration:
Please plan on arriving between 4PM and 5PM to register and get settled into your room.  The event officially starts at 6PM and we would like everyone to participate in the opening ceremony. No registrations/check ins will be allowed after 6PM on Friday during the opening ceremonies.  The registration desk will re-open again at 9PM and will continue to register attendees until 10PM.  If you cannot arrive by 10PM , a phone contact will be provided in the welcome letter which will be emailed close to the Summit start date.

Dress Code:
Casual - Make sure to pack warm clothing

Payments:
We will accept credit cards , checks and money orders for your Summit fees.  All money order and check payments must be received by OCTOBER 31ST to confirm your registrations and any unpaid registrations will be cancelled.  All checks or money orders should be made payable to NCCJS and mailed to NCCJS, PO Box 15422, Durham, NC  27704.

Cancellation Policy:
If you need to cancel your paid registration, please email the leadership team at info@ncclimatejustice.org and a refund will be processed within 15 days from the cancellation date.  An administrative fee of $20 will be deducted from the refund amount.

 

I agree to abide by these policies/procedures