EB Price Conference Registration Form

Conference Registration

Please register for the conference by filling out the form below
Payments are processed through Paypal. You may pay using an existing PayPal account, enjoy the 'Pay Later' Option, Venmo, or any major credit card / debit card.
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Are you currently in my Mighty Network?

YesNo
An Exclusive Conference Short Sleeve Tee is included. They will be Bella Canvas, what size do you want?*

SmallMediumLargeExtra LargeOther
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
Conference must be selected. Also, please only select ONE additional meal time with Coach Amy (choose ONE from Lunch 7/25, Dinner 7/26, OR Dinner 7/27)*
prevnext( X )
Conference
$315.00



Lunch with CA Thursday 7/25 (group of 5)1st come/1st serve Dutch Treat
$ Free Quantity



Dinner with CA Friday 7/26 (group of 5)1st come/1st serve Dutch Treat
$ Free Quantity



Dinner with CA Saturday 7/27 (group of 5)1st come/1st serve Dutch Treat
$ Free Quantity



Special Cafe Experience - Meet & Greet Thursday, July 25 5-7pmPlease 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



Total

$0.00

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

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