Waitlist Registration Form

Pacific Education Institute

Registration is Closed
I'm sorry, it has been 48 hours since your workshop registration link was released and it has expired. Please contact our Program Coordinator, Rachel Drummond, at rdrummond@pacificeducationinstitute.org to see if there is still an opening for this workshop and to request a new link.
Personal Details
Email Address
If you have taken workshops with us before, please provide the email you have used previously, if you still use that email. If you don't have a separate work email and personal email, you may enter the same email address in both fields.
Mailing Address
Please provide the address where you wish to receive your stipend check and/or workshop materials.
Workshop Materials
The workshop materials are available online. If there is a guide for this workshop we can mail it to you, if you prefer. Please indicate how you would prefer to receive the guide.

Note: If you prefer to have the guide mailed to you, we will use the mailing address you provided above. If you wish to receive your guide at a different address, please update your mailing address now.
Educator Details

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Additional Information



Meal Details
Meal details go here.

Travel Details
Travel details go here.

Attendee Waiver
Please review and accept this waiver in order to register for the workshop:

Acknowledgment of Risk: By registering for this workshop, I am aware that I will have the opportunity to participate in activities involving a degree of risk. Recognizing that the organizers will do their best to ensure a safe experience, I understand that certain dangers or accidents may occur. I understand that being out-of-doors for periods of time I may be exposed to natural elements. I am aware that participation in these activities is the choice of the individual and has inherent risks. These injuries or outcomes may arise from my own or other’s actions, inactions, or negligence, or the condition of the Activity location(s) or facility(ies). Nonetheless, I assume all risks of my participation in this Activity, whether known or unknown to me, including travel to and from the Activity (including air travel) or any events incidental to this Activity.

Release of Liability: I agree to release and indemnify the Pacific Education Institute (its directors, officers, employees, agents, and volunteers, collectively “PEI” from any loss, damage or cost incurred due to my participation whether caused by the ordinary negligence of the PEI releases or by any other person. I assume full responsibility for the risk of such loss, liability, damage, injury or death.
You must agree to the Attendee Waiver to complete this registration.
Video/Photo Release
Please review and accept this release if you are willing to have your image used for PEI's communications purposes:

I give permission for the Pacific Education Institute (PEI) to use, without limitation or obligation, video, photographs or other media that may identify or include the image or voice of me to promote or interpret PEI programs for any business purpose, including media coverage. I waive all claims for any compensation for such use.
Bilingual Confirmation
Note: If you are registering for a workshop that is for bilingual educators only, you must answer Yes below. If you answer No and you are registering for a workshop that is for bilingual educators, please be aware that your registration may be cancelled.
Email List Opt-In
Review Registration Information
PEI is not responsible for registration issues resulting from incomplete or inaccurate information.

Please verify that all of your information is entered correctly before clicking confirm.

If you hit confirm below and you are not taken to the next page, please scroll to the top of the form to see if there is an error message. If you have any questions about your registration, please contact our Program Coordinator, Rachel Drummond, at rdrummond@pacificeducationinstitute.org.

Contact Information