Please fill in your information below so we can arrange logistics & stay in touch.

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* 1. . Please provide your full name, phone and/or email contact, and your mailing address.

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* 2. Do you want to be added to the Olympic Climate Action email list?

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* 3. Check any ways you’ll help to organize for the Break Free event:

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* 4. If you intend to participate, how many are in your party and which days would you like to be in Anacortes (May 13, 14 and/or 15)?  More up-to-date info on day events can be found at http://breakfreepnw.org/action/.

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* 5. If intending to stay overnight, what accommodations would you consider?

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* 6. Preferred travel mode:

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* 7. I’m willing to drive others:

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* 8. Are you willing to engage in civil disobedience (including possible arrest)?  If you answer yes, would you like to have CD training and provide dates you would be available in comment box.

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* 9. If you cannot make the Anacortes event, do you want to help organize a local protest in the Port Angeles area?

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