SALT Conference 2020
DATES: Friday, Jan. 17th- Monday, Jan. 19th (3 days)
COST: Early Bird Registration cost is ONLY $199!
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Cell Phone Carrier *
Emergency Contact First & Last Name *
Your answer
Emergency Contact Phone Number *
Your answer
What is your gender? *
Whose small group are you in? *
We will accommodate rooms and rides for you! Are you able to attend the whole conference and depart from and return to Winona? *
If you answered "No" in the above question please explain why:
Your answer
What time are you able to leave on Friday, Jan 17th? *
Your answer
Can you drive? If yes, how many including yourself. (For example: Yes, 5) *
Your answer
Food Preference: For the various meals provided, we are able to accommodate the following dietary restrictions. Please check below if you need either accommodation. *
I understand that I am not fully registered until I have paid in full & signed my Winona State waiver *
In consideration of being allowed to participate in any way in the Great Plains North Chi Alpha North SALT, I understand and acknowledge that this Waiver and Release discharges Great Plains Chi Alpha from any liability or claim that I, the attendee, may have against Great Plains Chi Alpha with respect to bodily injury, personal injury, illness, death, or property damage that may result from my activities and time spent at the Great Plains Chi Alpha North SALT. I also understand that Great Plains Chi Alpha does not assume any responsibility for or obligation to provide financial assistance or other assistance to me, including but not limited to medical, health or disability insurance, in the event of injury, illness, death or property damage. I also grant to [Great Plains Chi Alpha], its representatives and employees the right to take photographs of me and my property in connection with the above-identified subject. I authorize [Great Plains Chi Alpha], its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that [Great Plains Chi Alpha] may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. *
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