Personal Information
Name 1 Name 2 Name 3 Name 4 Phone E-mail Credit Card Number (VISA, MASTERCARD or DISCOVER) NO AMEX! Expiration Date CCV Three Digit Security Code on Back of Card
Event Information (check all applicable boxes)
Coffee and Snacks at 8:30am, Seminar begins at 9am Lunch Provided Number of Adults 1 $40.00 2 $80.00 3 $120.00 4 $160.00 Number of Adults attending $40 each (15 and up) Number of Kids 14 and under 1 $10.00 2 $20.00 3 $30.00 4 $40.00 5 $50.00 6 $60.00 $10 for attendees under 15 Reserve your spot by March 5th
Number of Adults 1 $40.00 2 $80.00 3 $120.00 4 $160.00 Number of Adults attending $40 each (15 and up)
Number of Kids 14 and under 1 $10.00 2 $20.00 3 $30.00 4 $40.00 5 $50.00 6 $60.00 $10 for attendees under 15
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