Event Registration

First Name: Last Name: Email: Day Phone: Address: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico U.S. Minor Outlying Islands Virgin Islands Armed Forces Americas Armed Forces Europe, the Middle East, an Armed Forces Pacific Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Territory Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory Zip: - Zip Suffix Number of Attendees: Media Disclaimer: By registering for an event with CESA 12, participants agree to grant CESA 12 and its authorized representative's permission to record digital photos and/or video, (including virtual platforms) or their participation Participants further agree that any or all of the material photographed may by used, in any form, as part of any future publications, brochure, or other printed materials used to promote CESA 12, and further that such use shall be without payment of fees, royalties, special credit, or other compensation. Cancellation Policy: Any registration cancellation must be received by the registration delaine date for a refund to be issued. Persons registering and not in attendance on the day of the session will be charged the full registration fee (substitutions are accepted). CESA 12 reserves the right to cancel any session due to insufficient enrollment. Participants will be notified by email or phone if a cancellation occurs. If a workshop has been canceled due to weather conditions, every effort will be made to reschedule the workshop. Participants will be notified via email through NEONone if a cancellation occurs. Please make sure all your contact information is correct in NEONone.Dietary Disclaimer: CESA 12 makes every effort to accommodate basic dietary need such as vegetarian, gluten-free, and basic food allergies. CESA 12 does not assume liability for adverse reactions to food consumed or items one may come into contact with while eating at a CESA 12 event. To better serve our guests with dietary restrictions or allergies, please go into your NEONone account and update the special accommodations section. Notice of a special dietary need must be done at the time of your registration.