Conference Registration 2017

Conference Registration Form 2017

  • 1) We recommend that you print the conference brochure to see all the options, before completing this form.

    2) Fields will expand as you type into them.

    3) Use your TAB key or your mouse to skip from field to field. DO NOT use your "Enter" key!

    4) Fields marked with an * (asterisk) are REQUIRED fields.

    5) If clicking the SUBMIT button returns you to your form, that means there is an error on your form. Scroll through your form to find the error, which will be colored PINK.

    6) To add another row to a field, click the little + sign at the end of the first row.

    7) This is a complex form - PLEASE READ EACH ENTRY FIELD CAREFULLY.

  • ENTER ALL ATTENDEES IN THIS SECTION

  • FIRST and LAST name of attendeeIf Child, (under 12 years) state the child's ageIf a SOFT child, enter DIAGNOSIS and AGE hereIf attendee is for PICNIC ONLY, type PICNIC ONLY here 
    Add a new row
  • CONTACT & GENERAL INFORMATION SECTION

  • MEALS, CHILD OUTINGS & CHILD CARE SECTION:

  • Wild Mushroom RavioliLemon Herb Chicken BreastRed Wine Marinated Grilled Top SirloinKids Menu (under age 12): Chicken Tenders, Mac 'n Cheese, Carrots, Celery 
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  • Attendee's NameTurkey & Provolone SandwichHam & Swiss Cheese SandwichCranberry Creek SaladVegetarian Hummus Wrap 
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  • Turkey & Provolone SandwichHam & Swiss Cheese SandwichCranberry Creek SaladVegetarian Hummus Wrap 
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  • Child's NameParent's NameT-Shirt Size: Small, Medium, LargeIs T-Shirt size an ADULT or a CHILD size? 
    Add a new row
  • Child's NameParent's NameT-shirt size: Small, Medium, LargeIs T-shirt size an ADULT or a CHILD size? 
    Add a new row
  • Child's Name, Age & DiagnosisParent's NameWednesday (for Board Members Only)Thursday MorningThursday AfternoonFriday Afternoon (for Remembrance Outing and Clinic families only) 
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  • CLINIC AND WORKSHOP INFORMATION

  • CardiologyNeurologyGeneticsDevelopmental Peds/Complex CareOccupational TherapyPulmonaryOrthopedics 
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  • Feeding/NutritionGICommunication Aids and SystemsAudiologyENTPT 
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  • 1a TRIS Project Update1b Planning for Older Kids1c Jewelry Making1d Occupational and Speech Therapy2a Trisomy 18 & 13 Lecture2b Music Therapy3c Hippotherapy 
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  • 4a Hosting a SOFT Conference4b Vision, Light Sensitivity4c CPR Training4d Physical Therapy5a Dads Only5b Moms Only 
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  • TRANSPORTATION SECTION

  • Bus SeatsWheelchair Tiedowns 
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  • Bus SeatsWheelchair Tiedowns 
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  • SOFT-WEAR ORDERS (Note: You calculate the cost here but enter the QUANTITY (not the cost) in the payment section, toward the end of the form).

  • SmallMediumLargeExtra LargeEnter the Number of T-shirts Ordered:Calculate the Total Cost here: 
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  • SmallMediumLargeExtra Large (XL)2X (XXL)3X (XXXL)4X (XXXL)Enter the Number of T-Shirts Ordered:Calculate the Total Cost here: 
    Add a new row
  • SmallMediumLargeExtra Large (XL)2X (XXL)3X (XXXL)4X (XXXL)Enter the Number of Sweatshirts Ordered:Calculate the Total Cost here: 
    Add a new row
  • SmallMediumLargeExtra Large (XL)2X (XXL)3X (XXXL)Enter the Number of men's pullovers here:Calculate the Total Cost here: 
    Add a new row
  • SmallMediumLargeExtra Large (XL)2X (XXL)3X (XXXL)Enter the Number of women's pullovers here:Calculate the Total Cost here: 
    Add a new row
  • Registration PAYMENT Section (don't forget to add in shirts and special event costs!)

  • Price: $12.00 Quantity:
  • Price: $15.00 Quantity:
  • Price: $25.00 Quantity:
  • Price: $35.00 Quantity:
  • Price: $35.00 Quantity:
  • Price: $0.00 Quantity:
  • Price: $0.00 Quantity:
  • Price: $160.00 Quantity:
  • Price: $85.00 Quantity:
  • Price: $0.00 Quantity:
  • Price: $35.00 Quantity:
  • Price: $25.00 Quantity:
  • Price: $35.00 Quantity:
  • Price: $25.00 Quantity:
  • Price: $40.00 Quantity:
  • $0.00
  • Registration is not complete until payment is received by SOFT, through the PayPal system or receipt of a mailed check. After tapping the "SUBMIT" button, you will be taken to PayPal. Some computers and Internet connections are slow so be sure to wait for your PayPal login screen to appear!
  • YOU MAY SEND TWO PHOTOS - See the next two entries, below.

  • This field is for validation purposes and should be left unchanged.