Conference RegistrationFind Your MedicineBe The MedicineOctober 24 – 27, 2019 | Santa Fe, New MexicoName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Email* Cell Phone*Home PhoneName of Emergency Contact* First Last Relationship to you*Emergency Contact's Phone Number*Conference Deposit*A $100 deposit is required to reserve your spot at the conference. Deposits are non-refundable after September 24th. Final payments are due by October 10th. Price: $100.00 Participant AgreementThe purpose of my participation in the Find Your Medicine, Be The Medicine conference is for my education, enjoyment, and/or any other personal reason.I agree to take healthy risks, ask for help if needed, stay present, participate and collaborate during this event.I agree to be helpful, respectful and mindful of the presenters and other participants.I agree to respect my peers, volunteers, and conference staff, physically, mentally, emotionally and spiritually.I agree to be mindful of other participants sensitivities to fragrances and foods. This includes but not limited to items such as perfumes, essential oils, aftershaves, hand creams, sunscreen, bug spray, etc.I agree to set my device to silent and not use any electronic device for recording, photographing during presentations, texting, phone calls, social media, or music during conference presentations.I agree that I am in good health and have no physical or other impediment which would endanger me while participating in any activities.I agree to abide by the rules and regulations of the conference facility, The Lodge at Santa Fe.I agree and acknowledge that absolutely no firearms or weapons of any kind are allowed at this event.I agree that I am solely responsible for any property I bring with me and no one else, including Society for Shamanic Practice, volunteers, or conference center staff, will be liable for any missing or stolen property.I agree not to take any property that is not mine or commit any acts of violence. I know if I am suspected of doing anything illegal such as but not limited to these two actions then it will be reported to local law enforcement and dealt with outside of conference staff.I agree to release, discharge, waive and relinquish Society of Shamanic Practice (or its members, employees and volunteers) from any and all liabilities, claims, or actions for personal injury, property damage, or wrongful death which may arise out of my participation.SSP recognizes the importance of supporting family members on the shamanic path. I understand that children ages 10 and up are welcome at our events and are expected to uphold the same conditions as listed above.In the case I am an adult accompanying a minor, I agree to be responsible for the minor at all times and their compliance with this agreement, on behalf of myself, the minor and the larger group.I HAVE CAREFULLY READ THIS AGREEMENT, WAIVER AND RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND SOCIETY FOR SHAMANIC PRACTICE AND I SIGN IT OF MY OWN FREE WILL. Violation of these guidelines will result in immediate disciplinary action and/or removal from the conference. NOTICE OF PHOTOGRAPHYWhen you enter an SSP event or program, you enter an area where photography may occur. Please be aware that NO ceremonial, healing, or journeying will be photographed. SSP's intent is only to document the gathering of community for future storytelling and promotional materials. By entering the event premises, you consent to being photographed and its/their release, publication, exhibition, or reproduction to be used for promotional purposes, advertising, inclusion on websites, social media, or any other purpose by SSP. Images and photos may be used to promote similar SSP events in the future, highlight the event and exhibit the capabilities of SSP. You release SSP, its officers and employees, and each and all persons involved from any liability connected with the taking, recording, digitizing, or publication and use of photographs and computer images. By entering the event premises, you waive all rights you may have to any claims for payment or royalties in connection with any use, exhibition, or other publication of these materials, regardless of the purpose or sponsoring of such use, exhibiting or other publication irrespective of whether a fee for admission or sponsorship is charged. You also waive any right to inspect or approve any photo taken by SSP or the person or entity designated to do so by SSP. You have been fully informed of your consent, waiver of liability, and release before entering the event.I have read and accept the terms of the participant agreement.* Yes, I agree to the terms and conditions of this conference.Payment in Full*We are now in the late registration window, which is open through the evening of October 24th at 6:30PM. Because of this, payment in full is required in order to reserve your space. If you would like to take advantage of our $30 member discount, please become a member before completing this form.select one...Member ($195)Non-Member ($225)Coupon Would you like to make a donation to our conference scholarship fund?*This donation amount will be included in your total below, in addition to your total ticket cost.choose one...No, thanks.Yes, I'll donate $25.Yes, I'll donate $50.Yes, I'll donate $100.Yes, I'll donate the full price of a ticket, $225.Credit CardAmerican ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20202021202220232024202520262027202820292030203120322033203420352036203720382039 Expiration Date Security Code Cardholder Name Total $0.00 Terms & Conditions* I consent to having this website store my submitted registration information so that they can process my registration. 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