Registration

Register by credit card:

Enter your first name:
Enter your last name:
Enter location and date of requested workshop:
Enter total amount: (NOTE: please include the decimal and 0's like the following example - $209.00)
$209 for both days; $135 Friday only; $90 Saturday only; add $25 late fee if registering after Tuesday, week of workshop.
$109 Dietetic interns, full time students (send proof of registration);
Group discount: $185 each for 4 or more registrants.


Or fax or mail this form to:
Sports Nutrition Workshop, P.O. Box 650124, West Newton, MA 02465
Fax: (501) 526-5710 
Make check payable to Sports Nutrition Workshops

Name _________________________________________________

Institution ______________________________________________

Mailing Address _________________________________________

City/State/Zip ___________________________________________

Specialty/Type of Work ___________________________________

Phone (daytime) _________________________________________

E-Mail _________________________________________________

Location:    
___Chicago
___Detroit
___Indianapolis
___Columbus
___Minneapolis
___Dallas		 ___ St. Louis
___ Houston

Registration Fee:
_____$209    _____$135 Friday only     _____$90 Saturday only
_____$109 Dietetic interns, full time students (send proof of registration)
_____Group discount: $185 each for 4 or more registrants

Price includes refreshment breaks and handout materials.

Please register early. If registration is postmarked later than Friday one week before the workshop, add $25 late fee. Phone, fax, Web site or e-mail reservations are accepted the Monday and Tuesday before the workshop at $209; add $25 later fee after that.

Phone: (501) 821-3932  E-mail: NClarkRD@aol.com
Fax: (501) 526-5710 
Onsite registration: $25 fee for on-site registration, space available.

Cancellation: The fee less $35 will be refunded if notice is received by 4 p.m. on the Tuesday prior to the workshop. No refunds thereafter.

Want a roommate? With advance notice, we will try to match you up.

Payment: Check_____   Visa_____   MC_____   PO_____   Tax ID 04-2968-975

Credit Card # ____________________________________  Exp_____/_____

Signature ____________________________________

Make check (U.S. $) payable to Sports Nutrition Workshop and mail to:
Sports Nutrition Workshop, P.O. Box 650124, West Newton, MA 02465