Page 15 - summer2016

WISE TRADITIONS 2016 REGISTRATION FORM

First name Last name name for Badge
____________________________________________________________________________________________________________
organization/affiliation
____________________________________________________________________________________________________________
address
____________________________________________________________________________________________________________
city State Zip code country
____________________________________________________________________________________________________________
Phone Fax rcheck here if you are interested in donating food.
____________________________________________________________________________________________________________
E-mail Website rthis is my first Wise traditions conference.

mEmBERSHiP: become a member of the Foundation and receive our quarterly journal, full of informative
articles cHaPtER LEadERS
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+) $50 canadian/international ri plan to attend the chapter Leader meeting
thursday, nov 10, 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 Sept 15 after Sept 15 rWaPF journal rWaPF email
rFull Registration Student/Senior member $340. $390. rFriend/colleague rWaPF Postcard
rFull Registration Student/Senior non-member* $365. $415. rBlog rtwitter or FB
rFull Registration member $440. $490. rWeb advertisement rWaPF Website
rFull Registration non-member $480. $530. rPrint advertisement rRadio

rdaily Registration Student/Senior member* $135. $175. ranother conference rchapter
rdaily Registration Student/Senior non-member* $160. $200. rother, please specify__________________
rdaily Registration member $185. $225.
rdaily Registration non-member $225. $265. What is your current occupation?
rFriday dinner & Events $ 60. $ 85. rmedical Practitioner rFarmer
rSaturday Evening awards Banquet $ 75. $100. rnutritionist rHomemaker
r monday Guided Farm Visit 7-6, (includes lunch) $100. $100. rmassage therapist rStudent
r monday Homeopathy Workshop 9-4, (includes lunch) $100. $100. rchiropractor rRetired
r monday movement 9-4, (incudes lunch) $100. $100. rnurse rteacher
r monday treating adrenal Fatigue 9-4, (includes lunch) $100. $100. ragriculture ProfessionalrJournalist
r monday WaPF cooking 9-4, (includes lunch) $100. $100.
* Student/Seniors must show id. Senior is 62 and older. rartisan Worker rchef
rother, please specify__________________
if you are attending as a daily registrant, please indicate the day(s) you will be attending: PLEaSE FaX oR maiL tHiS FoRm to:
rFriday november 11 Registration includes conference materials, Friday sessions & Friday lunch Fax: (540) 301-3536
rSaturday november 12 Registration includes conference materials, Saturday joint sessions & Saturday lunch
rSunday november 13 Registration includes conference materials, Sunday sessions & Sunday brunch mail:
WaPF Wise traditions conference
Friday Seminar choice – please select one for planning purposes only, not binding. 1900 Jones Rd
rnourishing traditional diets rGaPS rHuman Health rFarming & Gardening rcooking/LifeStyle Winchester, Va 22602
Saturday choice – please select one for planning purposes only, not binding. contact:
rmain General Session: Pregnancy & children rWellness track rWeight Loss/diabetes Registration (540) 722-7104
registrar@ptfassociates.com or
Sunday Seminar choice – please select one for planning purposes only, not binding. WaPF (202) 363-4394
rElder care rmen’s Health rdental rVaccination rPractical/Lifestyle info@westonaprice.org

children's Program (child must be age 3-12 and potty trained.) Poster Presentations info:
______Child’s Name(s)______________________________________________________Age(s)______________ info@westonaprice.org
______@ $225 per child for Friday - Sunday includes Friday lunch & dinner, Saturday lunch, Sunday brunch PLEaSE notE:
rGF/cF meals oR r GF only oR r cF only for ____ children oR ____@ $150 per child, includes no one adult registration per form, please.
meals. Forms submitted without payment
cEUs 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, 2016
total due:______________rmastercard rVisa rcheck Payment/money order (make payable to WaPF)
FoR FURtHER inFoRmation
Full name ___________________________________________________________________________________ http://conferences.westonaprice.org/
card number________________________________________________________________________________
Exp. date_____________________________________Security code (3 digits on back of card)____________
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 18, 2016 to be eligible for a refund, less a $25.00 administrative fee. all refunds will be issued following the conference. Substitutions will be permit-
ted at any time. Registration packets will not be mailed and must be picked up on-site at the conference registration desk at the Renaissance montgomery Hotel.
Wise Traditions SUMMER 2016 Wise Traditions 15