2SLGBTQ+ Dinner

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Registration

Please fill out the whole form. Event is open to Native and NonNative Community, Families, Youth, LGBTQIA+ people, Allies, and Care-providers.

You will need both the youth/young adult and their parent/guardian to complete this form if under 18. You will receive a confirmation email once it is complete. If you do not receive the email, please reach out to Karen Asbury at karen@ncidc.org or 707-445-8451 to confirm that we have received your registration.

Thank you for your interest in the event! This dinner will be hosted in our 3rd floor theater room located at 517 3rd Street, Eureka Ca 95501.

All information provided on the form will be kept confidential and will not be shared with any external parties.

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Attendee Contact Information

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