IMPACT

IMPACT LEADERSHIP SERIES

REGISTRATION FEES:
Registration fee of $125 includes Workbook and Lunch or Dinner.
Eligible attendees must be 18 years old and a current Professional Member of the USASF.

NOTE: The IMPACT Leadership Series is an interactive and progressive workshop so space is limited. Register early for you and your staff to ensure you have a seat at the leadership table! The Leadership series has a limited space capacity therefore any cancellations 14 days prior to the event will incur a $50 cancellation fee. Sessions may not be recorded.

The IMPACT Leadership Workshop will be open for check in 30 minutes prior to the start time.

The course work is progressive so missing any one of the 5 classes is strongly discouraged and may disrupt the effectiveness of the course. Please be sure the attendee is able to be on time and stay for the entire course.

COURSE TIME: Course time: 9:00AM-5:15 PM

DATES & LOCATIONS:

Costa Mesa, CA - Saturday, June 2, 2018
Denver (Highlands Ranch), CO - Saturday, June 9, 2018
Atlanta, GA - Sunday, June 24th
Dallas, TX - Sunday July 15th
Boston (Fitchburg), MA - Saturday, July 21, 2018
San Antonio, TX - Saturday, July 28, 2018
Las Vegas, NV - Sunday, August 5th, 2018
Dallas, TX - Sunday, August 12, 2018
Orlando, FL - Saturday, August 25, 2018

If you are ready to proceed with registration for the IMPACT Leadership Series

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ATTENDEE INFORMATION

One attendee per form please.

First Name*

Last Name*

Organization (Program, Gym Name, etc)*

Organization Location (City, 2-letter State)*

What is your role/position?:*

Owner Program Director Coach Office/Administrative

Other:

Check as many as apply

I am involved in:*

Cheer Only Dance Only Both Cheer & Dance

ATTENDEE CONTACT INFORMATION

This information MUST be for the ATTENDEE

If you are filling this form out for someone other than yourself - DO NOT ENTER your personal contact information.

You will have the opportunity to enter an email for the receipt on the payment page.

ONLY ENTER THE INFORMATION FOR THE ATTENDEE !!

ATTENDEE'S Cell Phone Number*

Attendee's Email Address*

Confirm Attendee's Email Address *

LOCATION

Location:*

Costa Mesa, CA - Saturday, June 2, 2018 Denver (Highlands Ranch), CO - Saturday, June 9, 2018 Atlanta, GA - Sunday, June 24th Dallas, TX - Sunday July 15th Boston (Fitchburg), MA - Saturday, July 21, 2018 San Antonio, TX - Saturday, July 28, 2018 Las Vegas, NV - Sunday, August 5th, 2018 Dallas, TX - Sunday, August 12, 2018 Orlando, FL - Saturday, August 25, 2018

REGISTRATION FEES

The information on this page has been calculated for you based on your selections on previous pages.

Registration Fee $

TOTAL REGISTRATION FEE DUE $

Registration fees are 100% refundable up to 14 days prior to the event. Any request for a refund made less than 14 days prior to the regional meeting are subject to a $50 cancellation fee.

Name on Credit Card*

First Name

Last Name

Credit Card*

Credit Card Billing Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Email Receipt to*

Confirm Email Receipt to *

Refund

notes

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