MKW22 ORGANIZATIONAL REGISTRATION

Are established nonprofits and businesses with sustained operating budgets; characterized by full-time and part-time staff.
Name (Primary Contact)(Required)
Please select the option that best describes the location of your community:(Required)
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Address(Required)

EMERGENCY CONTACT

Emergency Contact Name(Required)
In case of emergency, please list an emergency contact that will be accessible during your participation at the 2022 Mni Ki Wakan Summit.
Address(Required)

YOUTH REGISTRANT (UNDER 18) TERMS & CONDITIONS

An adult must complete this form if the registrant (s) is under 18 years of age, and register separately. Youth under 18 years of age must be accompanied by an adult at all times. Organizations, programs, parents, or guardians assume full responsibility and liability for youth registrant (s) under the age of 18. By signing and registering a youth (s) under 18 years of age, you are verifying that you have obtained parental/guardian consent and the documentation to do so. The authorizer, parent, or guardian is solely responsible for the youth registrant and all associated responsibilities.
E-Signature (Authorizer/Parent/Guardian)
By signing my/our signature, date, we agree to and fully understand the terms and conditions of this agreement provided hereto, are 21 years of age or older, and have obtained parental consent to register the youth registrant (s) and are acting on behalf of the parent/guardian or are the parent/guardian. I/We understand and agree to accompany the youth at all times, and are solely responsible for the supervision, care, and safety of the youth. I/We, being of lawful age, by affixing my/our E-signatures hereto, do hereby agree to indemnify and to hold harmless the Mni Ki Wakan, its officers, employees, elected officials and agents, from and against any and all liability claims, actions, causes of action, demands, rights, damages, cost, loss of service, expenses, any health issues, and compensation for all negligence whether active or passive arising out of or in any way connected or related to the Mni Ki Wakan.
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MM slash DD slash YYYY
Address (Authorizer/Parent/Guardian)

MEDIA RELEASE FORMS, LIABILITY WAIVER, AND COVID-19 HEALTH & SAFETY PROTOCOLS

Media Release Form
Liability Waiver Form
COVID-19 Health & Safety Protocols

NEWSLETTER

Our team is building a Mni KI Wakan Ecosystem where Indigenous Peoples and youth are creating a transformative and sustainable future for water and all life together. We invite you to join our newsletter; receive updates, news, event info, and other relevant information.

COMPLETE PAYMENT

Have a credit/debit card on hand.