Planet 5p International Meeting Registration

International Meeting date: July 22, 2020

5p- Society Conference dates: July 23-26, 2020

Location: Eaglewood Resort & Spa, 1401 Nordic Road, Itasca, IL 60143

**Please note that this conference registration, does not include hotel reservations, travel or incidentals. Those will need to be done separately**

International Meeting and Conference Registration Form - International Participate

Thank you for registering to attend the 2020 5p- Society Annual Conference. We want to make the process as easy as possible. This year we will have an individual member registration fee of $100.00 (if you would like to register an an individual, please go to this link: https://5psociety.regfox.com/2020-5p-annual-conference-member-individual-registration) and a family member registration of $200.00 for four people in the same family. Each additional person will be one price of $50.00 (must be of the same family). Two separate 5p- Society families cannot register under one registration form. You will have the opportunity to let us know if you want a child's or adults meal for your family member. Registrations received after July 1, 2020 will pay a late fee of $50.00. If you have any questions, please send an email to [email protected]..

If you are only attending the International Meeting on Wednesday, July 22, 2020, there is a box below that you can check. It will ask you for your name, email address and phone number. If you plan to attend the entire conference, please check the appropriate box and continue to fill out the form.

If you have any questions at any time, please contact Laura at [email protected].

New this year, we are asking for email addresses for each registrant (optional). The email address will be used for the conference app.

T-shirts

T-shirts may be ordered below. To guarantee your t-shirt order is received, please submit no later than June 15, 2020. There will be a limited supply of extra shirts at the conference for purchase. However, to guarantee your size, please order below. T-shirts will be delivered at the conference. If you are not attending the conference but would like to order T-Shirts, please send an email to Laura at [email protected] and she can send you a form.

If you have any questions about this conference registration, please call 1-888-970-0777.

Registration Options

International Meeting Only ($0.00)
If you check this box you are only attending the International Meeting on Wednesday July 22, 2020. There is no fee to attend just this meeting.
Family Registration-Member ($250.00)
Family Registration is for four individuals of the same family - children or adults. Regular registration will be $250.00 after July 1, 2020.

Registration Information - Please fill out this form for your Family Registration. The Family Registration is for up to four individuals of the same family. This can be either adults or children. For children, we will be asking if you would like an adult or child's meal. Please provide email addresses for as many individuals as you would like for the conference app.

Individual 1 Name

Individual 1 is . . .

Will Individual 1 need child care?

If Individual 1 needs child care, how old are they?

If Individual 1 is a sibling will they be attending the sibling outing?

Meal Type

T-Shirt Size (optional)

Individual 2 Name

Individual 2 is . . . .

Will Individual 2 need child care?

If Individual 2 needs child care how old are they?

If individual 2 is a sibling, will they be going to the sibling outing?

Meal Type

T-Shirt Size (optional)

Individual 3 Name

Email address

Individual 3 is . . .

Will you need child care for individual 3?

If Individual 3 needs child care, how old are they?

If Individual 3 is a sibling, will they be going to the sibling outing?

Meal Option

T-Shirt Size (optional)

Individual 4 name

Email address

Individual 4 is . . .

Will you need child care for Individual 4?

If Individual 4 needs child care, how old are they?

If Individual 4 is a sibling, will they be going to the sibling outing?

Meal Option

T-Shirt Size (optional)

Phone Number

Address

Please register your additional individuals below. Each additional individual will be $50.00.

Number of Additional Individuals

($50.00/ea.)

Individual 5 Name

Individual 5 is . . .

Will Individual 5 need child care?

If Individual 5 needs child care, how old are they?

If Individual 5 is a sibling will they be attending the sibling outing?

Meal Type

T-Shirt Size (optional)

Individual 6 Name

Individual 6 is . . . .

Will Individual 6 need child care?

If Individual 6 needs child care, how old are they?

If individual 6 is a sibling will they be attending the sibling outing?

Meal type

T-Shirt Size (optional)

Individual 7 Name

Individual 7 is . . .

Will Individual 7 need child care?

If Individual 7 needs child care, how old are they?

If Individual 7 is a sibling will they be attending the sibling outing?

Meal Type

T-Shirt Size (optional)

Individual 8 Name

Individual 8 is . . .

Will Individual 8 need child care?

If Individual 8 needs child care, how old are they?

If Individual 8 is a sibling will they be attending the sibling outing?

Meal Type

T-Shirt Size (optional)

Individual 9 Name

Individual 9 is . . .

Will Individual 9 need child care?

If Individual 9 needs child care, how old are they?

If Individual 9 is a sibling, will they be attending the sibling outing?

Meal Options

T-Shirt Size (optional)

Individual 10 Name

Individual 10 is . . .

Will you need child care for individual 10?

If Individual 10 needs child care, how old are they?

If Individual 10 is a sibling, will they be attending the sibling outing?

Meal Type

T-Shirt Size (optional)

Individual 11 Name

Individual 11 is . . .

Will you need child care for Individual 11?

If Individual 11 needs child care, how old are they?

If Individual 11 is a sibling, will they be attending the sibling outing?

Meal Type

T-Shirt Size (optional)

Individual 12 Name

Individual 12 is . . .

Will you need child care for Individual 12?

If Individual 12 needs child care, how old are they?

If Individual 12 is a sibling, will they be attending the sibling outing?

Meal Option

T-Shirt Size (optional)

How many Family Fun Event tickets do you need? This will assist us with both transportation and food for the event. Individual with 5p- Syndrome is free!

($3.00/ea.)

Would you like to renew your membership with the 5p- Society?

Photo Release:
I/we acknowledge that I may be photographed, or recorded. I hereby release to the 5p‐ Society all proprietary rights and copyrights in all such photographs, digital images, voices, recordings, actions, films and likenesses (including negatives, positives and prints) which shall be and remain the property of the 5p‐ Society. I understand that this material may be used in various publications, public affairs releases, recruitment material, and broadcasts or for other related endeavors. This material may also appear on the 5p‐ Society’s website, and other public social media sites.

I expressly release the 5p‐ Society, its directors, officers, employees, agents and volunteers, from any and all claims, including copyright and privacy, arising out of any reproduction, broadcast, distribution, publication, or promotion of this event.

Signature - Please sign to acknowledge the Photo Release

Did you drive or fly?

Are you staying at the conference hotel or elsewhere, please indicate.

Did you request a crib from the hotel?

Did you request a refrigerator from the hotel?

Do you need a high chair?

Donation in Lieu of attending

Convenience Fee

$0.00

Sub Total

$0.00

If you are a scholarship recipient or have received a coupon code, please enter the code that you received here and hit "apply"

Total

$0.00

Purchase ProtectionRECOMMENDED

Add Purchase Protection for a small fee and get a 100% refund of your registration purchase should you be prevented from attending due to a qualifying unforeseen circumstance. (Full Terms)

Why protect your registration purchase? Purchase Protection covers:

Severe Illness and Injury

COVID-19

Hospitalization

Death in Family

Transportation Failure

Crime and Home Emergency

Employment Obligations

Acts of Nature

Legal Obligations

Purchase Protection covers many common unforeseen circumances, but exclusions apply. View full List of qualifying circumstances and exclusions.

Yes, protect my event registration purchase (Recommended)

No thanks, I am willing to risk losing $0.00. I understand I cannot add this later.

* Terms, conditions and exclusions apply. Not available for or applicable to events, attendees, or travel outside of the USA. Purchase Protection is a service offered by Purchase Protection LLC. Purchase Protection is not an insurance policy. It is a service that will refund you 100% of your event fees, taxes and dues should you be prevented by unforeseen circumstances from attending the event. Purchase Protection does not apply to, and will not reimburse, merchandise purchases and charitable donations. Purchase Protection fees will be charged as a separate transaction. Any changes made to your purchase will not change the amount covered in this agreement.

Read Full Terms and Conditions

Billing Information

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Address

Phone Number

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