Earth Intimacies: Writing Into the Animate Web
Wild Nature Heart
April 25, 2026
2:00 PM - 4:00 PM
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TRANSLATE THIS FORM: Español, Português, Tiếng Việt, Tagalog, Kreyòl ayisyen
FOR WHOM?
I WILL PARTICIPATE
YOUR (PARENT/GUARDIAN) NAME:
YOUR (PARENT/GUARDIAN) CONTACT INFORMATION:
NAME:
(not parent)
CONTACT INFORMATION:
(OPTIONAL)
GENDER:
Please enter a gender information here...
use button or write in anything!
Male
Female
Non-Binary
PRONOUNS:
use button or write in anything!
He/Him/His
She/Her/Hers
They/Them/Theirs
LANGUAGE:
(only if not English)
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HOUSEHOLD/FAMILY DETAILS:
PARTICIPANT MAILING ADDRESS:
* ONLY IF OUTSIDE OF USA
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HOW DID YOU FIND US?
Please help us understand
which of our marketing efforts are most effective
by checking the factor or factors
that most influenced your decision to register!
WORD-OF-MOUTH:
heard about it from a friend or family member
WEB:
searched for something on the internet and found your website
SOCIAL-MEDIA:
saw something on social media: Instagram, Facebook, etc.
GROUP:
participated as part of our school or other group program
EMAIL:
received a marketing email or e-newsletter from you
BROCHURE:
received or read a printed brochure or program catalog
POSTER:
saw a poster on a bulletin board
PRINT:
saw a printed advertisement or article in a newspaper or magazine
ADVISOR:
A school counselor, advisor, or paid consultant recommended it
ENCOUNTER:
randomly encountered your staff or students while we were out in the world
EVENT:
found your table or display at a school, fair, or other public event
MYSTERY:
A mysterious force has led me here; I cannot explain it
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YOU MUST CHOOSE ONE OF THESE OPTIONS:
$40.00
TUITION A-SUPPORTING-TIER-EARTH-INTIMACIES
This tuition tier supports those paying on the lower end of the scale and helps Journeys develop future programs
$30.00
TUITION C-SUSTAINING-TIER-EARTH-INTIMACIES
This tuition tier covers our direct costs of running the program
$20.00
TUITION D-SUPPORTED-TIER-EARTH-INTIMACIES
This tuition tier falls short of covering our direct expenses
SHOPPING CART
ADJUST QUANTITIES:
ITEM
QUANTITY
SUBTOTAL
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NEWSLETTER OPT IN
Please opt in below to be added to our newsletter email list!
Would you like to be added to our newsletter to receive occasional emails about our programs and community updates?
YES
NO
SUBMIT THIS SECTION
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ALMOST DONE, KEEP GOING!
PLEASE COMPLETE THIS VALIDATION:
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