Event Registration

About This Form

This form is to be filled out by a co-op administrator on behalf of any co-op members who wish to attend a PHCHF event. The administrator will be our billing contact for paid events. It is not required that they attend any events themselves.

Co-op Administrator

Select any events you will attend yourself (optional):

Other Participants

Please provide the details of all co-op members, other than the administrator above, who will be attending any events. You may add up to 10 additional participants per form submission.

No events have been selected. Please either select an event for the co-op administrator to attend themselves, or add someone else as a participant.
Please enter valid information in all fields outlined in red.