FWRA CONFERENCE 2019 REGISTRATION FORM
October 3rd – October 6th, 2019 • Florida FFA Leadership Training Center • Haines City, Florida
Registration is open to all interested parties, FWRA members or not, who are at least 18 years of age.
Serious students ages 14 to 17 may register as Youth Attendees with an Attending Sponsor; an additional application form (PDF) is required. Payment is accepted by check or PayPal.

  If paying by check please mail registration form with your check to:
FWRA            PO Box 411087        Melbourne, FL  32941  

  • Please register early to keep down our costs & yours!  Early registration rates are good until September 12, 2019 and the price increase will be on the web site after that date.
  • Refunds for cancellations after September 14, 2019 are at the discretion of the board of directors.
  • The Leadership Training Center DOES NOT allow animals (pets or rehab patients) on the property.
  • Smoking is not allowed in the rooms but is permitted outside in designated areas.
  • Please respect their rules. Violation of these rules may cause member to be asked to leave and no refund will be issued.
  • This form is for enrollment purposes and registration is not completed until payments are received.

 
  Personal Information  
 
Click Here for Instructions
Registration Instructions

Fill all appropriate information and click submit at the bottom of the page. You can print a copy for your records before submitting the registration by clicking on the PRINT button.

Payment submission

By Check
After completing your registration print the form using the PRINT button at the bottom of the form. Mail your registration with payment to:

Florida Wildlife Rehabilitators Association
P.O. Box 411087, Melbournne, FL 32941  


By Credit Card/Paypal
After clicking the SUBMIT button, you'll be redirected to a page with the option to pay using PayPal.

 

 


 
 

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Emergency contact:

(Person to call in case you have a medical emergency)

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I'm an FWRA member

       ($25.00 charge will be added to non-member registration) Click here to save by joining the FWRA now!

Please renew my membership

Memberships are now renewable in September. For your convenience, you may renew with registration.

   

For corporate memberships please see the membership section of the web site.

Networking Mailing List

FWRA plans to provide a list of names, affiliations & email addresses to all conference attendees for easier networking. Please advise if you would like your information to be included in this list:

Please make a selection.
 

Accommodations

I need vegetarian meals:
Please make a selection.

I need vegan meals:
Please make a selection.

I need a DOWNSTAIRS room:
(Assigned on a space available basis)
 
 

Full conference includes room on Thursday, Friday, and Saturday nights and breakfast, lunch, dinner and snacks on Thursday, Friday and Saturday, and breakfast on Sunday. Wednesday night check-in additional charge. These are FWRA member rates. All rates are per person. Non-members add $25.00 or join FWRA

All Inclusive Packages (Conference, Lodging & Meals)

Double Occupancy

If you do not have a roommate, we can attempt to match you with another member.

Please find me a roommate:
(Ice breaker reception and snacks on Wednesday evening)
Single Occupancy

Conference & Lunch Only

Daily rates include lunch and snacks only, no breakfast, dinner or room.

Select day(s) you will be attending:
Select night(s) for dinner:
 

Symposium Theme T-shirt

Included with registration

T-Shirt Size:

Sizes are guaranteed with registrations received by September 12th.

Additional T-Shirts

Pre-order additional t-shirts at $10.00 each to guarantee available sizes. A limited number of shirts will be available at the conference. Additional t-shirt information will be on Facebook soon.

Enter quantity for each size:


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Use this button to print a copy of your registration for your records.  

   
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Florida Wildlife Rehabilitators Association
P.O. Box 411087, Melbourne, FL 32941