Attendee Contact Information

Prefix Title

Name

Address

Institution

Phone Number

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Registration Fee

Registration Options

$Sub-Total

$0.00

Online Fee

$0.00

******Please note- a .0354% online payment convenience fee will be added to credit card payments.******

$Total

$0.00

Terms & Agreements

FORMS OF PAYMENT
Individual checks will be accepted Until May 1, 2017. After May 1, 2017, only Institutional checks, money orders or cash will be accepted. No personal checks will be accepted on site. Returned checks will result in a $35.00 processing fee.

CANCELLATION/CHANGE/REFUNDS
Registration – written request must be received by Ronald Range no later than May 15, 2017. A fifty dollar cancellation fee will be assessed. Emergency request received in writing and documented after May 15, 2017 will be reviewed on a case by case basis.

Changes must be submitted in writing by fax or mail.

HOTEL RESERVATION GUIDELINES
Please see hotel information form enclosed, to register for hotel accommodations. Please contact hotel directly or visit their direct online site reservation link:
https://aws.passkey.com/g/20247763
Please remember to cancel your hotel reservation three business days prior to your arrival date to receive a refund.

I have read and agree to the terms above.

Billing Information

Name

Payment Method: Select one:

Credit Card
Paying by check (If paying by check, click the "SUBMIT" button to complete registration form

Credit Card

Visa
Mastercard
American Express
Discover

Address

This page is secured with 256 bit encryption

Event Registration Software by RegFox