Registration Form for November 20, 2021Workshop for WomenWorkshop for Women on November 20 PERSONAL INFORMATION Name * Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming 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
