Conference Registration Form

Conference Registration

Please register for the conference by filling out the form below
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
By signing this form, you agree that you understand the information and itinerary disclosed in the document below. I will also be creating a group on Mighty Networks for registrants to communicate, coordinate and meet each other.
Signature*

Clear
Date*

MonthDayYear
Date
*PLEASE MARK if you will attend the cafe Thursday evening. Then the first 20 ladies to register may choose ONE VIP Option. Thanks!! *
prevnext( X )
Special Cafe Experience - Meet & Greet Thursday, July 18 5-7pm
Please confirm your attendance here. Dinner will be served & included in the fee above. Please only choose 1. Family and Friends are not allowed at this private event, only conference attendees

$ Free Quantity



VIP Option #1 Winery Outing Friday afternoon (group of 5)
$40 due by June 1 via link that will be available later. *Selecting this commits you to the outing. Must have valid ID.

$ Free Quantity



VIP Option #2 Dinner with CA Friday 7/11 (group of 5)
1st come/1st serve Dutch Treat - Reservation has been made at Puckett's in Franklin. *Selecting this commits you to the outing.

$ Free Quantity



VIP Option #3 Country Music Hall of Fame & Museum + Dinner/Honky Tonk with CA Saturday 7/12 (group of 10)
1st come/1st serve $36 (for museum ticket) due by June 1 via link that will be available later. Dinner is Dutch Treat. *Selecting this commits you to the outing.

$ Free Quantity



Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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