REGISTRATION

PRINTABLE MAIL-IN REGISTRATION FORM

ONLINE REGISTRATION FORM IS BELOW – When you submit the form it will open a secure PayPal window for payment using a credit card.

2025 CONFERENCE REGISTRATION – No Merchandise

Name *

First

Last

Other Family Members Attending (Spouse/Children)

Registration fee covers the entire family!

Name for Conference Badge – 1

First

Last

Name for Conference Badge – 2

First

Last

Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone Number *

Email *

Email

Confirm Email

Family Registration *

Price: $65.00

Includes admission to the whole conference for you and your family – $65

Banquet Meals – Adults $35 (Age 13 and up), Youth $20 (Age 12 and under) – Check a box for each meal ticket

• 1st Adult – $35 – $35.00
• 1st Youth – $20 – $20.00
• 2nd Adult – $35 – $35.00
• 2nd Youth – $20 – $20.00
• 3rd Adult – $35 – $35.00
• 3rd Youth – $20 – $20.00

All you can eat seafood banquet on Friday May 16th at 5pm – NOTE: IF MORE THAN ONE PERSON IS ATTENDING – YOU NEED TO CHECK THE BOX FOR THE ADDITIONAL PEOPLE (e.g. If two Adults – Check BOTH 1st Adult and 2nd Adult – if you only check one box, you only get one ticket) Apologies for any confusion – there not a way to add a quantity option on this particular form.

Emergency Contact NAME *

First

Last

Name of person to contact in case of emergency

Emergency Contact – PHONE *

Phone number to call contact in case of emergency

Email Newsletter

• I would like to receive email updates regarding future conferences

Comments or Questions

Note – All attendees of conference will need to sign an ACKNOWLEDGMENT, NOTICE AND RELEASE to attend the conference before you will receive your conference badge.

Total

Order Summary

Item	Quantity Qty	Total
There are no products selected.
Family Registration	1	$65.00
Banquet Meals – Adults $35 (Age 13 and up), Youth $20 (Age 12 and under) – Check a box for each meal ticket – 1st Adult – $35	1	$35.00
Banquet Meals – Adults $35 (Age 13 and up), Youth $20 (Age 12 and under) – Check a box for each meal ticket – 1st Youth – $20	1	$20.00
Banquet Meals – Adults $35 (Age 13 and up), Youth $20 (Age 12 and under) – Check a box for each meal ticket – 2nd Adult – $35	1	$35.00
Banquet Meals – Adults $35 (Age 13 and up), Youth $20 (Age 12 and under) – Check a box for each meal ticket – 2nd Youth – $20	1	$20.00
Banquet Meals – Adults $35 (Age 13 and up), Youth $20 (Age 12 and under) – Check a box for each meal ticket – 3rd Adult – $35	1	$35.00
Banquet Meals – Adults $35 (Age 13 and up), Youth $20 (Age 12 and under) – Check a box for each meal ticket – 3rd Youth – $20	1	$20.00
Total		$65.00

$0.00

PayPal Commerce *

PayPal CheckoutCredit Card

Card Number

Expiration Date

Security Code

Card Holder Name

Phone

Submit

Pressing [PayPal] button will take you to PayPal to make payment or if you select credit card it will be processed by PayPal directly from page and you will need to hit [Submit]. If you don’t complete payment we will not be able to register you.