Conference Online Registration Form

Conference Online Registration

October 27th-29th,2023 Salt Fork Lodge,Cambridge Ohio
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
Phone Number*
Name of Emergency Contact

First NameLast Name
Number of Emergency Contact
Is this your first time to attending a women's conference?*

YesNo
What is one thing about the Wounderful Women's Conference that made you want to attend?
What is one thing that you would like to achieve by attending this conference?
What is one Christian song that inspires or uplifts you? *
This song will be displayed on your name tag. It will be added to a playlist of songs that will be played at various times during the conference!
Please indicate dietary requirements:*

NoneVeganVegetarianKosherGluten FreeCeliacAllergy NutOther
If you selected "Other" please list the allergy below:
Do you have accessibility needs?

YES (if yes please select below)NOOther
If you selected "Other" please list below:
There will be a conference photographer at this event. Will you allow photograph to be taken?

YESNO
*Photographs will be used for future conference promotion.
LODGING INFORMATION

Conference Center: https://www.saltforkparklodge.com

Early bird rate of $156 per room-per night.

(to receive the early bird rate a deposit of one night must be provided directly to the lodge by August 25, 2023).

Please Call: 1.740.435.9000 to make reservations.

Use the Wounderful Group Code: WW23
In consideration for participating in this conference, I acknowledge and agree that the organizer is not responsible or liable for any illness, including that resulting from COVID-19, or injuries or loss that may occur to me or my property as a result of my participation in the conference.

The information provided at The Wounderful Conference is for educational and informational purposes only and solely as a self-help tool for your own use. The information provided is not a replacement for psychotherapy or a coaching relationship. Always seek the advice of your own Medical Provider and/or Mental Health Provider regarding any questions or concerns you have about your specific health concerns.

I am fully aware and take responsibility of the dangers, hazards, and any risks involved in my participation, and I know and understand that unanticipated injury or events might arise during the course of the conference. I hereby assume all dangers, hazards, and risks arising from my participation in the conference and hereby release, waive, discharge, and covenant not to sue The Wounderful Conference, or any of its representatives, agents, and contractors (collectively, the “Releasees”) from any and all losses, liabilities, claims, demands, damages, actions, or causes of action (collectively, “Losses”) which may arise out of my participation in the conference.

I further agree to indemnify and hold harmless the Releasees from any and all Losses arising out of or relating to my participation in the conference. It is my intent that this release binds the members of my family and my heirs, assigns, and personal representatives.
I have read the above conference considerations:*

I agree
Secure your spot at the conference and/or a spot for someone else.
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Conference Regisration Fee 1 guest
$315.00

Scholarship DonationIf you'd like to donate more towards this conference please update your quantity below.
$10.00 Quantity

Total

$0.00
Thank you for registering!

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