Participant Contact Information

Name

Please include the type of license for your continuing education credits

Do you have another license for which you would like CEUs?

Title/Position

Confirm Email

I understand that all notifications regarding Boot Camp, including last minute changes, such as location, will be sent to this email address.

Please provide the best phone number where we can reach you in the event that there is a last-minute change in venue.

Phone Number - work

Phone Number - cell

Facility

Facility Parent Corporation

Address

Registration Information

Registration includes access to all handouts which can be downloaded from the Resources page of our website. You will be sent the password to access the handouts with confirmation of your registration. You can purchase a Handout Booklet for $30 that you will receive at the time you register, the first day of the conference.

Registration Options

Live In-Person ($499.00)
Attend the 2-day course in person. I will print my own handouts.

Registration includes access to all handouts which can be downloaded from the Resources page of our website (you will be sent the password with confirmation of your attendance).

Also included is a continental breakfast and lunch both days.

Vegetarian Lunch Requested

Please check if you would like a vegetarian lunch both days.

Handout Material

All of the session handout material will be available for you to download and print from our website's Resources page. You will receive the password to access this page with your registration confirmation.

Or you can purchase the handout materials in a bound booklet for $30.

Booklet
Booklets will be provided on-site at Boot Camp.
A limited number will be available for purchase on-site.
$30.00 ea.
Add
Floating Frame
A floating frame is available for purchase to display your Certificate of Training in Infection Prevention and Control. The certificate displays the course curriculum on the back so the floating frame is a perfect way to frame your certificate.

A limited number will be available for purchase on-site.
$10.00 ea.
Add

Running Total

$499.00

IPCR Reference

Total

$499.00

For a copy of our W-9 form, click the link this link: IPCR W-9 form.pdf

Or go to the registration page on our website at www.InfectionPreventionResources.com.

Cancellation Policy:

No refunds will be given after September 11, 2019.
If you need to cancel prior to that date, please notify us and we will process your cancellation at the following refund rate:
Notification by August 28, 2019: 100% refund
Notification by September 11, 2019: 50% refund
Notification on or after September 11, 2019: no refund

This course may be live-streamed over the internet and recorded. I understand that if I am attending in-person I may be visible in the audience to those viewing the course on-line.

I have read and agree to the terms above.

Additional Information regarding cancellations or changes:

Please note the following:
We recognize that circumstances arise such that you find you are unable to attend at the last minute. If that occurs, we cannot transfer your registration to another person but can send a coupon that can be used by another person to register. If this occurs within two days of Boot Camp, a $50 administrative fee will be applied.

I have read and agree to the terms above.

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