ACLP Group Registration Form READ BEFORE PROCEEDING Thank you for registering for our webinar. To enroll as a group, please fill out the form on the next page. If you plan to register for multiple webinars, please submit a separate form for each registration if the number of participants varies.Disclaimers No additional registrants can be added or removed once the group registration is processed. This form is for individual webinars only. ACLP packages, series, and bundles are priced at a different rate. For inquires and assistance, email us at education@childlife.org. Please note that it may take up to 3-5 days to process group registrations. Once completed, you will receive a confirmation email that includes further instructions, an invoice, and access information.Please be aware that each webinar has an access time limit, and it is your responsibility to finish the contents and save your certificate before it expires.Each participant in the group registration must have an ACLP account. The registration spreadsheet (ROSTER) must include their ACLP account ID, name, and email associated withthe their ACLP account. Incomplete information will result in non-registration due to account verification issues.If you don't have an account yet, you can create one by visiting www.childlife.org. Group Registration Rates Per Webinar Group Size Price 4-5 $132 6-9 $220 10-15 $363 16-25 $594 26-34 $880 35-49 $1,210 50-74 $1,815 75+ $2,750 Question Title * 1. Name of Registration Organizer (Required.) Question Title * 2. Email Address (Required.) Question Title * 3. Company/Hospital Name (Required.) Question Title * 4. Official Webinar Title (If listing multiple items, please number them sequentially (e.g., 1, 2, 3). (Required.) Question Title * 5. Registration Level (Required.) 4-5 participants 6-9 participants 10-15 participants 16-25 participants 26-34 participants 35-49 participants 50-74 participants 75+ participants Question Title * 6. Please enter the first name, last name and email address for each individual attending the webinar. Done