Step 1 of 4 25% RegistrationInput the number of registrants into the appropriate field(s) below. Please include yourself. Adult* Price: $45.00 Quantity: Type the Number 0 if you have none for this field.Adult* Price: $55.00 Quantity: Type the Number 0 if you have none for this field.Student* Price: $35.00 Quantity: Type the Number 0 if you have none for this field.Student* Price: $45.00 Quantity: Type the Number 0 if you have none for this field.Religious* Price: $35.00 Quantity: Type the Number 0 if you have none for this field.Religious* Price: $45.00 Quantity: Type the Number 0 if you have none for this field.Please type either your "Parish", "City" and/or "School" (for Students) in the last field. To add more registrants, click on the plus sign on the right. List all registrants (Including yourself).Add More Registrants*If you have Dietary Requirements please contact Lynne Chapman @ email@example.com or 563-556-2580 Ext 246FIrstLastemailPhoneParish/City/School T-ShirtsShirts will be handed out at registration on Saturday at the Conference. Group orders will be given to the group contact. T-shirt purchases are optional and not required for Conference attendance. Orders placed after January 10, 2018 are not guaranteed. The shirts are a 4.5 oz., pre-shrunk 100% ringspun cotton, unisex/men's cut. Click to see full size. S T-Shirts Price: $20.00 Quantity: M T-Shirts Price: $20.00 Quantity: L T-Shirts Price: $20.00 Quantity: XL T-Shirts Price: $20.00 Quantity: XXL T-Shirts Price: $20.00 Quantity: Pre-Event socialFriday, January 26th 8-9:30 p.m. Location: DoubleTree by Hilton Hotel Cedar Rapids Convention Complex Relaxed social, speakers present. $12, Includes light snacks and one complimentary non-alcoholic beverage. Cash bar available. Pre-Event social Tickets are optional and not required for Conference attendance.Pre-Event social Price: $12.00 Quantity: timestampPaymentBilling InfoName* First Last EmailConfirmation email will be sent to this address Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code If you were a winner of a free registration at a Beauty Alive event, please enter the code below. If your total after adding the code is $0.00, you will not need to input your credit card info.Credit Card American ExpressDiscoverMasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20172018201920202021202220232024202520262027202820292030203120322033203420352036 Security Code Cardholder Name Sub-TotalRegistrationsRegistrationsT-shirtsPre-Event SocialTotal $0.00 This iframe contains the logic required to handle Ajax powered Gravity Forms.