Register multiple staff for the 2019 Birth Institute, or send this link to your staff so they can fill out the questions for themselves.  If you have more than 4 staff members to register, complete the survey a second time until all have been recorded.
You can select to call the office with your credit card information, receive an email with links to pay each invoice online (each registration will create a separate invoice) or mail a check with the final total.

This survey does not include pricing; visit aabcbirthinstitute.org to review pricing for registration and special events.
 
Registration and attendance at, or participation in, AABC meetings and other activities constitutes an agreement by the registrant to the use and distribution of the registrant or attendees' image or voice in photographs, videotapes, electronic reproductions and audiotapes of such events and activities by AABC and other third parties, including but not limited the venue, the host city and the host CVB.

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* 1. How will you be paying?

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* 2. If you selected for us to email you with payment information, provide the email address that we should contact.

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* 3. Registrant #1

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* 4. Emergency Contact Person for Registrant: Name and Phone number  
(Can be another attendee)

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* 5. Dietary Restrictions (e.g. vegetarian, gluten-free, peanut allergy, none, etc.)

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* 6. Preferred Pronouns:

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* 7. Which registration does this person need? (Additional discounts will be subtracted as appropriate)

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* 8. If you selected 2 Day or 1 Day Registration, let us know which days: Friday, Saturday, Sunday (Thursday is not charged)

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* 9. Which meals are you planning to attend?

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* 10. This registrant will require tickets to the following workshops/events:

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* 11. I would like to register a 2nd staff member.

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