WSRCA Roadshow

Event ID

Event Location

Event Date

Event Details

Name*

First NameLast Name

Company*

Email*

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

How many people are you registering?

Select how many attendees you are registering for each session time below. All sessions cover the same content — choose the time/language that works for your group.

8:30am - Spanish: 1 hour 45 minutes

10:30am - Spanish: 1 hour 45 minutes

1:30pm - Spanish: 1 hour 45 minutes

3:30pm - English: 1 hour 45 minutes

Total Registered:

Attendee Names (Required for Cards)

Enter first and last name of each attendee. Use the attendee’s legal name (no nicknames). Names will be printed on the Fall Protection Awareness cards exactly as typed.

✅ All attendee names entered. You can submit the form now.

Almost done: You still need to enter {namesRemaining} attendee name(s).
Click + Add Attendee and enter first & last name for each person.

You entered {namesOver} extra attendee name(s). Please remove {namesOver} row(s) from the list above.

Names Entered

Names Remaining:

Names Over

YesNo

This exclusive event is for WSRCA members only. Not a member yet? Join today and enjoy a 20% discount on your membership!

Contractor Membership - 20% Discount

$556

Major Manufacturer - 20% Discount

$988

Roofing Equipment/Specialty Manufacturer - 20% Discount

$700

Area Distributor/Supplier- 20% Discount

$556

Roofing Consultant - 20% Discount

$556

Service Provider - 20% Discount

$556

Architect/Engineer - 20% Discount

$272

Insurance Agent/Broker - 20% Discount

$948

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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