Page 23 - Summer2015

WISE TRADITIONS 2015 REGISTRATION FORM

MEMBERSHIP: become a member of the Foundation and receive our quarterly journal, full of informative CHAPTER LEADERS
articles as well as sources of healthy food. WAPF members receive a conference registration discount. rI am a chapter leader.
r$40 US Regular Annual Membership r$25 US Student or Senior (62+) r$50 Canadian/International rI plan to attend the Chapter Leader Meeting
Thursday, Nov 12, 10 am - 4 pm
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.
How did you hear about the conference?
By Aug 14th After Aug 14th rWAPF journal rWAPF email
r Thursday FTCLDF FundRAISER Event Adult $ 85. $ 85. rFriend/colleague rFlyer
r Thursday FTCLDF FundRAISER Event Child (12 and under) $ 60. $ 60. rBlog rFacebook
rFull Registration Student/Senior Member $340. $390. rWeb advertisement rWAPF website
rFull Registration Student/Senior Non-Member* $365. $415. rPinterest/Twitter rRadio
rFull Registration Member $440. $490.
rFull Registration Non-Member $480. $530. rAnother conference rChapter
rDaily Registration Student/Senior Member* $135. $175. rOther, please specify__________________
rDaily Registration Student/Senior Non-Member* $160. $200. What is your current occupation?
rDaily Registration Member $185. $225.
rDaily Registration Non-Member $225. $265. rMedical Practitioner rFarmer
rFriday Dinner & Events $ 60. $ 85. rNutritionist rHomemaker
rSaturday Evening Awards Banquet $ 75. $100. rDentist rStudent
rMonday Farm Tour (7:30-5, includes lunch) $100. $100. rChiropractor rRetired
r Monday Homeopathy Workshop (9-4, includes lunch) $100. $100. rNurse rTeacher
r Monday Movement Workshop (9-4, includes lunch) $100. $100. rAgriculture Professional rJournalist
r Monday MRT Workshop (9-4, includes lunch) $100. $100. rArtisan Worker rChef
r Monday Raw Milk Series (9-4, includes lunch) $100. $100. rOther, please specify__________________
rMonday WAPF Cooking Workshop (9-4, includes lunch) $100. $100.
* Student/Seniors must show ID. Senior is 62 and older. PLEASE FAX OR MAIL THIS FORM TO:
Fax: (540) 301-3536
If you are attending as a daily registrant, please indicate the day(s) you will be attending: Mail:
rFriday November 13 (Registration includes conference materials, Friday sessions and Friday lunch.) WAPF Wise Traditions Conference
rSaturday November 14 (Registration includes conference materials, Saturday joint sessions and Saturday lunch.) 1900 Jones Road
rSunday November 15 (Registration includes conference materials, Sunday sessions and Sunday brunch.) Winchester, VA 22602
Friday Seminar Choice – please select one for planning purposes only, not binding. Contact:
rNourishing Traditional Diets rGAPS Diet rFarming rCooking rWellness Track Registration (540) 722-7104
Saturday Seminar Choice – please select one for planning purposes only, not binding. registrar@ptfassociates.com or
rPlenary Session: Focus on Fats rWellness Track rFarming & Gardening WAPF (202) 363-4394
info@westonaprice.org
Sunday Seminar Choice – please select one for planning purposes only, not binding.
rFood & Nutrition rLyme Disease rHeart Disease rWater rMaking it Practical Poster presentations info:
info@westonaprice.org
Children's Program (Child must be age 3-12 and potty trained.)
______Child’s Name(s)_______________________________________________________________Age(s)_______
PLEASE NOTE:
______@ $225 per child for Friday - Sunday includes Friday lunch & dinner, Saturday lunch, Sunday brunch One adult registration per form, please.
rGF/CF meals OR r GF only OR rCF only for ____ children OR ____@ $150 per child, includes no meals. Forms submitted without payment
Continuing Education Credits for RNs & LAcs. A $5 certificate of attendance is available. It suffices for RDs & nutritionists. will not be processed.
rRN rLAc; rAll 3 days $65 rFriday $25 rSaturday $25 rSunday $25/rRD or nutr.rCert of Attend. $5. NO REFUNDS will be issued after
Payment Processing December 31, 2015.
Total Due:______________rMasterCard rVisa rCheck Payment/Money Order (make payable to WAPF) FOR FURTHER INFORMATION
Full Name_____________________________________________Security Code (3 digits on back of card)_____ conferences.westonaprice.org/
main-conference/
Card Number _________________________________________Expiration Date__________________________
By submitting this form, I authorize Wise Traditions to charge the applicable registration fees. I understand that all cancellations must be submitted in writing and must be received
by October 17, 2015 to be eligible for a refund, less a $25.00 administrative fee. All refunds will be issued following the conference. Substitutions will be permitted at any time.
Registration packets will not be mailed and must be picked up on-site at the conference registration desk at the Anaheim Marriott Hotel.
Wise Traditions SUMMER 2015 Wise Traditions 23

154242_V16N2_text.indd 23 6/25/15 3:54 PM