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WISE TRADITIONS 2011 REGISTRATION FORM

First Name Last Name Name for Badge
____________________________________________________________________________________________________________
Organization/Affiliation
____________________________________________________________________________________________________________
Address
____________________________________________________________________________________________________________
City, State, Zip Code, Country
____________________________________________________________________________________________________________
Phone Fax
____________________________________________________________________________________________________________
E-mail
____________________________________________________________________________________________________________
r Check here to reserve GF/CF conference meals. A separate GF/CF buffet is provided at all meals, except the banquet where you'll receive the GF/CF plate with
a special dinner ticket. Register for GF/CF children's meals below.
CHAPTER LEADERS
Full Conference Registration includes Conference Materials, Friday Sessions, Friday Lunch, Friday Dinner,
Saturday Sessions, Saturday Lunch, Saturday Evening Awards Banquet, Sunday Sessions and Sunday Brunch rPlease check here if you are a
chapter leader.
By August 1 After August 1
rFull Registration Student/Senior Member* $290. $340. rI plan to attend the Monday
rFull Registration Student/Senior Non-Member* $315. $365. Chapter Leader Meeting.
rFull Registration Member $390. $440.
rFull Registration Non-Member $430. $480. What is your current occupation?
rMedical Practitioner rFarmer
rDaily Registration Student/Senior Member* $120. $160. rNutritionist rHomemaker
rDaily Registration Student/Senior Non-Member* $145. $185. rMassage Therapist rStudent
rDaily Registration Member $170. $210. rChiropractor rRetired
rDaily Registration Non-Member $210. $250. rNurse rTeacher
rFriday Dinner & Events $ 60. $ 85. rAgriculture Professional rJournalist
rSaturday Evening Awards Banquet $ 75. $100.
rMonday Radical Nutrition Seminar (8-4, incudes lunch) $ 75. $ 85. rOther, please specify__________________
rMonday Farm Tour (8-4, includes lunch) $ 75. $ 85.
rMonday Poultry Workshop (8-4, includes lunch) $ 75. $ 85. PLEASE COPY THIS PAGE AND
rMonday Cooking Workshop (8-4, includes lunch) $ 75. $ 85.
* Student/Seniors must show ID. Senior is 62 and older. FAX OR MAIL IT TO:
rThursday, November 10 FTCLDF On-Farm FundRAISER $ 75. $ 95.
Fax:
If you are attending as a daily registrant, please indicate the day(s) you will be attending: WAPF Wise Traditions Conference
(304) 724-3007
rFriday November 11 Registration includes Conference Materials, Friday Sessions and Friday Lunch
rSaturday November 12 Registration includes Conference Materials, Saturday Joint Sessions and Saturday Lunch
rSunday November 13 Registration includes Conference Materials, Sunday Sessions and Sunday Brunch Mail:
WAPF Wise Traditions Conference
Friday Seminar Choice – please select one for planning purposes only, not binding. 159 Jenny Lind Drive
Harpers Ferry, WV 25425
rTraditional Diets rGut & Psychology rNutrition & Metabolism rBiodynamic Farming rFood Prep
Contact:
Saturday Choice – please select one for planning purposes only, not binding. Conference Registration (304) 724-3006
rMain General Session: Mythbusters rWellness Track rFarming & Activism Track registrar@ptfassociates.com
or
Sunday Seminar Choice – please select one for planning purposes only, not binding. WAPF (202) 363-4394
rRecovery rChildren’s Health rHormonal rEnvironmental rNutrition info@westonaprice.org
Childcare (Child must be age 3-12 and potty trained) Poster Presentations Info:
Child’s Name(s)_______________________________________________________________Age(s)_______ info@westonaprice.org
_____@ $210 per child for Friday - Sunday includes Friday lunch, Friday dinner, Saturday lunch and Sunday
brunch rGF/CF meals for _____ children OR _____@ $100 per child, does not include meals
Continuing Education Credits
rFriday, $25. rSaturday, $25. rSunday, $25. rAll 3 days, $65. rCert of Attendance $5. PLEASE NOTE
One adult registration per form, please.
Payment Processing Forms submitted without payment
Total Due:______________rMasterCard rVisa rCheck Payment/Money Order (make payable to WAPF) will not be processed.
Full Name Security Code (3 digits on back of card)
_____________________________________________________________________________________________
Card Number and Expiration Date FOR FURTHER INFORMATION visit
_____________________________________________________________________________________________ www.westonaprice.org/
By submitting this form, I authorize Wise Traditions to charge the applicable registration fees. I understand that all cancellations conferences/2011conference
must be submitted in writing and must be received by October 22, 2011 to be eligible for a refund, less a $25.00 administrative
fee. All refunds will be issued following the conference. Substitutions will be permitted. Registration packets will not be mailed and
must be picked up on-site at the conference registration desk at the Sheraton Dallas Hotel.
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