Registration Form for November 20, 2021Workshop for WomenWorkshop for Women on November 20 PERSONAL INFORMATION Name * Address * Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Phone * Email * Diet * Notice that your registration will only go through once you click SUBMIT. The payment can only be processed by accessing the PAYPAL BUTTON separately on this page.The prices below include the registration fee and one or two meals on Saturday, November 20. A surcharge will be added for credit card and PayPal payments. If you prefer to complete your registration through PayPal make sure you proceed to click on the PayPal button once you have submitted all your information. $40.00 (+ $1.31 cc fee) = $41.31 (Saturday with 2 meals) $30.00 (+ $1.11 cc fee) = $31.11 (Saturday with 1 meal)COVID WAIVER RELEASE OF LIABILITY AND ASSUMPTION OF RISK Signature * Clear Print Name and Date * If you are human, leave this field blank. Submit Registration optionsSaturday participation - one meal $31.11 USDSaturday participation - two meals $41.31 USD
