Non-Member Registration Form

Name*

First

Last

Phone:*

Area Code

 - 

Phone Number

E-mail:*

Physical Address:*

Street Address City State / Province / Region Postal / Zip Code

Name of Local Affiliated Club: (Enter "none" if you have no local club membership)*

How did you hear about our conference?*

Non-Member Registration: Full Conference*

Full Conference (Friday w/Beek Bash, Saturday) - Non-Member BEFORE Jan 31st - $80

Full Conference (Friday, Saturday) - Non-Member AFTER Jan 31st - $80

Optional Add On: Saturday Box Lunch includes choice of sandwich, bagged chips, baked cookie, tea/water. Please select the desired sandwich option below.*

No Lunch Desired

Chicken Salad - $15

Club Wrap - $15

Grilled Veggie Wrap - $15

Refund Policy:

Requests may be submitted through the "Contact Us" form on the main conference web page.

Refunds requested  before January 31, 2024 will incur a $25 fee to be subtracted from the refund.

Registrations cancelled after January 31, 2024 are NON-REFUNDABLE.

Total:

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Online Payment Information

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