2009 JPD Spring Conference

Please fill out the following form to register for the JPD Spring Conference 2009.
NOTE: Click Here to reserve a hotel room at the Doubletree Hotel Wilmington

Registration Information: *Denotes required field.
PRIMARY CONTACT
*First Name:
*Last Name:
*Address1:
Address2:
*City:
*State:
*Zip Code:
Phone:
*Email Address:
Home Congregation:

*Registration Fees:
 A $25 late fee per registrant will be added on April 2nd, 2009.
Select the number to register for each category.
Adult (35+)
$145
Names:
Young Adult (18-35)
$95
Names:
Youth (1st-12th grade)
$50
Names:
Infants through Kindergarten (< 1st grade)
FREE!
Names:
*Meals:
Please indicate your meal choice for each registrant:
Saturday Lunch::  
# of Vegetarian Adult meals  # of non-Vegetarian Adult meals
   
# of Vegetarian Child meals  # of non-Vegetarian Child meals
Breakfast buffet and continuous breaks will be provided on Saturday for all conference participants. Vegetarian options will be available.
If you have allergies or dietary restrictions that would preclude you from choosing any of the above options, please let us know here:

IMPORTANT: WE CANNOT GUARANTEE MEALS FOR REGISTRATIONS RECEIVED AFTER APRIL 17, 2009.


*Workshops:
  
For complete workshop details, download the conference packet here.
*Attendee Name:
1st Session:
1st Session - Second Choice:
2nd Session:
2nd Session - Second Choice:
3rd Session:
3rd Session - Second Choice:
Attendee Name:
1st Session:
1st Session - Second Choice:
2nd Session:
2nd Session - Second Choice:
3rd Session:
3rd Session - Second Choice:
Attendee Name:
1st Session:
1st Session - Second Choice:
2nd Session:
2nd Session - Second Choice:
3rd Session:
3rd Session - Second Choice:
Attendee Name:
1st Session:
1st Session - Second Choice:
2nd Session:
2nd Session - Second Choice:
3rd Session:
3rd Session - Second Choice:
Youth Name:
Age:
Program:
Youth Name:
Age:
Program:
Youth Name:
Age:
Program:
Youth Name:
Age:
Program:
Registration of Minors (under 18)
As primary contact and custodian of all minors (persons under age 18) listed on this registration, I grant permission for said minors to participate in this conference as indicated on this registration form.
Electronic Signature of Custodian/Primary Contact:
Photography Release
As primary contact listed on this registration form, I accept and acknowledge that any and all conference participants may be photographed or recorded during conference events.
Electronic Signature of Custodian/Primary Contact:

EXHIBIT SPACE REGISTRATION
Exhibit space is provided on a first come, first served basis. Space is limited. Exhibits MAY need to be confined to half of a 6 foot table. More information will be provided once all requests have been processed.
Would you like to reserve exhibit space? yes:
Name of group:
Contact person: Name E-mail
Scholarship Fund Donation: If you would ike to make a donation to the JPD Scholarship Fund to help offset registration and travel costs for Spring Conference attendees in need, please fill in a value in the box below.
Donation Amount: $