Personal Information:
Participant name, address and email will be published in the Participant List (given in welcoming packet at Educational Conference).
If you do not wish to be listed, please check here:
Do not list my info in the welcome packet.

First Name:  

Last Name:

Mailing Address:

City: State:   Zip:

Country:

Home Phone Number: Country Code:

E-mail Address:
Cellular Phone:

Profession:

I am a Chapter Member: Yes No  
Country Chapter:

Do you speak or understand English? Yes No

What languages do you speak?

Would you be able to assist with translation? Yes No

Volunteers
We are seeking individuals to volunteer translation in these areas (please check boxes):
Registration Table - Welcoming and Registration Friday, October 3rd
International Night - Friday, October 3rd
Workshop Translation - to be determined
Media Table Sales - to be determined

Activities
Please indicate which activities you will participate in:
I will attend International Association Infant Massage-Sweden Educational Conference - Friday, October 3rd through Sunday, October 5th at OMNI Resort.

CONFERENCE FEES:
Conference Registration (October 3-5, 2008)
Chapter Member: Educational Conference (Friday - Sunday): 
By 8/29/08 $265.00 USD After 8/29/08 $340.00 USD

Non-Member: Educational Conference. Includes a one year
membership to Infant Massage USA® (Please complete application)
By 8/29/08 $340.00 USD After 8/29/08 $370.00 USD

I will attend the Founder’s Banquet - Saturday October 4th with honored guest Vimala McClure; By 8/29/08 $65.00 USD After 8/29/08 $70.00 USD.

I will attend General Assembly (free) on October 6th and 7th at the OMNI Resort.

I will attend Infant Massage USA® 1st Annual GA Luncheon Meeting on October 4th USA members only; By 8/29/08 $25.00 USD After 8/29/08 $30.00 USD.

I would like to present a poster at the International Night on Friday, October 3rd (limited space available.)
 Subject of poster:

I have materials pertaining to our activity to show or for sale. I request information on renting a Country Chapter or Vendor Table.
Please email vendor.2008@infantmassageusa.org by August 29.

Fees and Payment Information
Register by August 29th for BEST Prices

Conference Registration (October 3-5, 2008)
Chapter Member: Educational Conference (Friday - Sunday): 
By 8/29/08 $265.00 USD After 8/29/08 $340.00 USD

Non-Member: Educational Conference. Includes a one year
membership to Infant Massage USA® (Please complete application)
By 8/29/08 $340.00 USD After 8/29/08 $370.00 USD

Founder’s Banquet (Saturday night)*
Featuring honored guest and founder, Vimala McClure $65.00 USD $70.00 USD
By 8/29/08 $65.00 USD After 8/29/08 $70.00 USD

Infant Massage USA® (USA members only)*
1st Annual General Assembly Luncheon Meeting $25.00 USD $30.00 USD
(Saturday October 4th, noon)
By 8/29/08 $25.00 USD After 8/29/08 $30.00 USD

*Please indicate your preference for Banquet and/or Luncheon:
Vegetarian meal Mixed (meat, veggies)
Any particular food allergy/sensitivity?

Please Enter The Total Registration Fees Due
DO NOT ENTER ANY "$" SYMBOLS.
(USING THIS FORMAT: 000.00)
Please enter the amount you are paying  $
Click on the "Go to Payments" Button to continue.

Cancellation policy :
Cancellation by August 29th: 80% refund
Cancellation by September 15th: 50% refund
Cancellation after September 15th: no refund

Cancellations must be received by email to:
register.ga2008@infantmassageusa.org