2020 ACA San Diego Planning Guide_Winter Conference

ACA FAMILY AUXILIARY REGISTRATION 2020 Winter Conference • San Diego • Jan. 9–14, 2020

Name of Conference Attendee ____________________________________________________________________________ (Registered conference attendee. Family member registering under Family Auxiliary. Cannot be employed in corrections.)

Name of Spouse Attending:

Name _______________________________________________________________________

Names and Ages of Children Attending:

Name _______________________________________________________________________

Age ________________

Name _______________________________________________________________________

Age ________________

Name _______________________________________________________________________

Age ________________

Address ________________________________________________________________________________________________

City ____________________________________________________________________________________________________

State ________________________________________________________ ZIP code ________________________________

Auxiliary Registrant’s Occupation ________________________________________________________________

Auxiliary registration: $95 per family in advance (or $110 on-site) $ ________________ *You must pay this fee if you wish to participate in conference-related activities.

Payment

Enclosed is my check in the amount of $ ____________________ , Check #____________________ , made payable to ACA.

I wish to pay with my Visa Mastercard AMEX Discover Diners Club Cash

PRINT Cardmember Name__________________________________________________________________________________

Cardmember Signature (required) ____________________________________________________________________________

Credit Card Number

Exp. Date

V-code

*Registrations cannot be accepted at the advance rate after Dec. 13, 2019. No refunds for Family Auxiliary Program registration will be made unless a written request is received on or before Dec. 13, 2019. All programs are subject to change. ACA reserves the right to cancel or alter an activity in the event of extenuating circumstances.

Please check this box if you wish to opt out of conference mailings/emails. *Please note that if this box is not checked you will automatically be added to the conference list. If you wish to be removed please contact conference@aca.org.

FORM B

50 — ACA 2020 Winter Conference | San Diego