Please enable JavaScript in your browser to complete this form. – Step 1 of 2Class Date *June 27-28th Washington D.C.September 12-13th ChicagoNovember 14-15th SeattleName *FirstLastCompany *Title *Phone *Address 1 *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Module 1 *Single Seat – $1,500.00Double Seat – $3,000.00Triple Seat – $4,500.00Name Person 2 *FirstLastCompany *Title *Phone *Address 2 *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Name Person 3 *FirstLastCompany *Title *Phone *Address 3 *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *NextUpdating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes.Total$0.00Name *FirstLastName as it appears on CardPayment *Card NumberMM123456789101112Expiration/YY2425262728293031323334Security CodeBilling Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeTerms *AgreePayment for Registration Disclaimer By proceeding with the registration process and making a payment, you agree to the following terms and conditions: Registration Fee: The payment you make serves as the registration fee for the event, service, or program mentioned. Accuracy of Information: You certify that all information provided during the registration process is accurate and complete. Any discrepancies may result in the cancellation of your registration without refund. Payment Authorization: By providing payment information, you authorize, Gans Gans and Associates(authorize.net verified merchant), to charge the specified amount to the provided payment method. Cancellation and Refunds: Cancellation policies vary depending on the specific event, service, or program. Please refer to the terms and conditions provided during the registration process for information regarding cancellation deadlines and refund eligibility. Transferability: Registrations are typically non-transferable unless explicitly stated otherwise. You may not transfer your registration to another individual without prior approval from the organizers. Event Changes or Cancellation: We reserve the right to make changes to the event, service, or program, including but not limited to changes in date, location, agenda, or speakers. In the event of cancellation, we will provide a refund according to the terms outlined in the cancellation policy. Liability: We are not liable for any loss, damage, injury, or inconvenience resulting from the event, service, or program, including but not limited to travel expenses, accommodation costs, or any other incidental expenses. Privacy: We respect your privacy and will handle your personal information in accordance with our privacy policy. By completing the registration process and making a payment, you acknowledge that you have read, understood, and agree to abide by these terms and conditions. PreviousSubmit