Copy of CMS Bootcamp - January 2018 Leesburg, VA Registration Information Question Title * 1. Please complete your contact information: First Name Last Name Title Address City/Town State/Province ZIP/Postal Code Email Address Phone Number Question Title * 2. I understand that by submitting this form that I have registered for the CMS Bootcamp - January 2018 Leesburg, VA and that training and meals will be secured for me and will be paid by SkillsUSA. If I have need to cancel my registration, I will do so as soon as possible so that the room can be released. I understand that I am responsible for my transportation (airfare or driving if applicable). Agree Not agree Submit Registration