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2nd Annual Chiropractic Conference on Children’s Health and Wellness and
Family Wellness Spectacular
April 24-27,2008
 
Location: Atlanta, Georgia
 
REGISTRATION FORM
26 Hours CE* - Applied for, approval pending
Registration Information:
Doctor's First Name: 
Doctor's Last Name: 
Office Address: 
Suite / Box #: 
City: 
State: 
Postal/Zip Code: 
Country: 
Phone: 
Cell: 
Fax: 
Email:
Note: A Registration Confirmation will be sent to you via Email.

How Did You Hear of Us:
Early Bird Registration Tuition:
$195* WCWF / WMA / KDAI Active Members
(see below for 5 bonuses included in Advanced Registration price)
$345 Chiropractor
$65 Student/Faculty
Tuition Includes DC and up to 4 people from office (5 registrants total) and special bonuses.
$575 Regular Price

1. DC may bring up to 4 people from office for free ($600 value)
2. Public Relations Press Kit package and training for Children’s Chiropractic Month May 2008 
    ($395 value)
3. Audio Program “How to Get the Most out of the Conference” ($95 value)
4. Three months of “Practice with the Warners” pediatric practice management training & leadership coaching
    ($1,035 value)
5. Chiropractic Media Training Coupon ($200 value)

Registrant Name:
Registrant #1: 
Registrant #2: 
Registrant #3: 
Registrant #4: 
Registrant #5: 
Payment Details:
Please charge my: Visa Mastercard Discover American Express
For the total of: (adjust total based on classification)
Card Number: 
Expiration: 
V-Code  (Last 3 digits on back of credit card)
Name On Card: 
 
 

Notice: By clicking submit, you authorize the seminar investment fee selected above to be charged to the indicated credit card and you understand and agree to the financial and cancellation policy listed below.

CANCELLATION POLICY: All cancellations received prior to 60 days before the conference must be in writing and are subject to a 25% administrative fee "or" can be applied to a future, similar program. Any cancellations after 60 days preceeding the conference date will not be honored but can be applied to a future, similar program.
        

 

   
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