SheRise Summit Registration Form
Empower. Evolve. Excel.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Business/Organization Name
Title/Position
Reason for Attending the Conference
Hotel Accommodations Needed?
Yes
No
There will be photography and/or videography. By attending this event, you understand this and agree that your image, if, captured, may be used for the business purpose(s) of the collaboration team.
Yes
No
If yes, specify number of nights
Any special dietary requirements
I understand that I am holding a spot so reservations for this event are nonrefundable. If I am unable to attend, I understand that I can transfer to a friend. In this scenario, I will contact sherisesummit@gmail.com com
Yes
No
My Cart
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VIP Admission
Includes lunch, snacks, an exclusive dinner, makeup, headshot, 1-1 consulting/coaching.
$
699.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
General Admission
$
349.00
Additional Comments
Submit
Should be Empty: