CADBI 2019 Rally Registration Form
NOTE: REGISTRATION FOR THE BUSES FROM PHILADELPHIA IS ON STANDBY. WE CANNOT GUARANTEE SEATS ON THE BUS--WE WILL NOTIFY YOU IF SEATS BECOME AVAILABLE.

This form is for people interested in attending "On Both Sides: Rally to End Death by Incarceration and Heal Our Communities", which will take place in Harrisburg on Wednesday October 23. The rally will start at 12pm at the Capitol Rotunda in Harrisburg, but buses from Philadelphia will be leaving from 46th St and Market St (next to the Aldi) at 8am.

If you have any trouble filling out this form, or have any additional questions, please feel free to contact us by phone at 267-606-0324 or by email at CADBIphilly@gmail.com
Name *
Your answer
Phone Number *
Your answer
Email
Your answer
What is the best way to contact you? *
Required
How many other people are traveling with you to the rally?
If other people are traveling with you to the rally, what are their full names?
Your answer
Where are you traveling to the rally from?
CADBI will be arranging buses to the rally from Philadelphia for those who do not have their own transportation. Would you like to reserve a seat on the bus from Philadelphia? *
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service