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Use this form to RSVP for various Conservancy events that require a registration for planning purposes.
Photo Disclaimer: By
registering and/or attending any Burke Centre Conservancy event, I
understand that publicity photographs/videos may be taken during the event and
my likeness may appear in these images. By registering or attending the event,
I hereby give permission that photos and/or videos containing my likeness may
be used for publicity or general information purposes, not limited to, The
Burke Centre Conservator, the Burke Centre Conservancy web site, Burke Centre
presentations, etc. which may be seen in the general public. The Burke Centre
Conservancy will typically not seek further permission or provide notification
before using such images. Thank you for your cooperation.
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| Today's Date: | * |
| Name: | * |
| Address: | * |
| Email: | * |
| Contact Phone #: | * |
| Number of Guests (Family Members-please include everyone in total): | * |
| Participating Children's Ages (everyone under age 18): | * |
| Name of Event: | * |
| If 'Other' selected, please provide the name of the event/meeting: | |
| Comments/Notes: | |
| To prevent automated SPAM, please enter 11QQ to submit your form (case sensitive): | * |
* indicates required field
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