RTDC 2023
Registration Form
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
City and State of Residence
*
Social media profile names:
How did you hear about the conference? If you heard from another registered attendee, please list their name here:
*
Name, Email Address, City/State for each additional registered guest (if more than one was paid for on this form):
If you are registering through the AMBASSADOR program, please enter the name of your AMBASSADOR here. (Please enter N/A if not applicable)
*
My Products
*
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( X )
General Admission (GROUP RATE)
Group of 5 or more
$
99.00
Quantity
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
VIP (GROUP RATE)
Includes VIP luncheon, Conference Shirt and Preferred Seating. (Select 1 shirt size for each VIP registrant)
$
199.00
T-Shirt Size
Quantity
S
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
M
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
L
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
XL
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
2X
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
3X
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
4X
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Please list Name, Email, and Phone # (and Tshirt Sizes for VIP) for each registrant.
*
Submit
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