Conference Registration Form 2022

Minnesota Association for Developmental Education Conference Registration Form

September 22 - 23 at Chase at the Lake in Walker, MN
Name *

First Name Last Name
E-mail *
Position
Preferred Phone Number *
Institution *
If "other", please list:
Select your area(s) of interest: *

Reading Mathematics Writing Counseling/Advising ESOL Other
If "other", please list:
Please help us with accurate meal counts.

You will need a ticket for each meal during the event, which are determined by this registration form.
Will you be joining us for lunch on Thursday (12:00 - 12:50 pm)?

Yes No
Will you be joining us for dinner on Thursday (5:30 - 6:30)?

Yes No
Will you be joining us for lunch on Friday (12:45 - 1:30 pm)?

Yes No
If you have any dietary restrictions, please list them here and we will do our best to accommodate your needs.

No Dietary Restrictions Vegan Vegetarian Dairy-Free Gluten-Free
Payment *

I plan to pay using a credit card/PayPal/vemo. I plan to send a check. I plan to pay by institutional check. I am a presenter. (One conference fee waived per session.)
Upon submission you will be redirected to the MNADE payment page.

(Complete by midnight, September 1st for the early bird discount.)
If you are presenting, your conference fee is waived.

Please pay the 2023 membership of $20.00.
MNADE will be following the most current CDC and MNSTATE Covid-19 guidelines to provide the safest conference possible given current conditions. We ask that you plan to use prevention strategies such as wearing masks, physical distanding, hand hygiene, etc. throughout the conference.

Also, by submitting this form, you agree to the following Attendee Waiver and Release of Liability:

I HEREBY ASSUME ALL OF THE RISKS OF ATTENDING THE EVENT IN-PERSON, INCLUDING WITHOUT LIMITATION THE RISK THAT I MAY BE EXPOSED TO OR BECOME INFECTED WITH COVID-19. I HEREBY, FOR MYSELF AND MY HEIRS, SUCCESSORS, AND ASSIGNS, AND ALL THOSE CLAIMING BY OR THROUGH ME, WAIVE, RELEASE, AND AGREE TO DEFEND, INDEMNIFY, AND HOLD HARMLESS MNADE AND ITS AGENTS FROM AND AGAINST ANY LIABILITY, LOSS, EXPENSE, OR OTHER DAMAGE-INCLUDING PERSONAL INJURIES, PROPERTY DAMAGE, DEATH, COSTS OF COURT, AND ATTORNEY’S FEES –ARISING FROM OR IN CONNECTION WITH THE EVENT, INCLUDING THOSE WHICH ARISE OR ARE ALLEGED TO ARISE FROM THE NEGLICENCE OF ANY INDEMNITEE.

I understand that MNADE does not provide accident or medical insurance regarding my participation in the Event.
Registration fees:
- The MNADE Conference rate is $80.00 through September 1st (plus $20.00 membership), the MNADE Conference rate after September 1st is $120.00
- Presenters: your conference fee is waived. If there are multiple presenters, one conference fee will be waived per session. Please pay your 2023 membership ($20.00)
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Minnesota Association for Developmental Education Conference Registration Form

Please help us with accurate meal counts.