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

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Phone Number - cell

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Facility

Facility Parent Corporation

Address

Please indicate below whether you have received the COVID-19 vaccine. Thank you.

Please indicate whether you have received the COVID-19 vaccine.

I received the 1st dose of the COVID-19 vaccine only
I have received both the 1st and 2nd doses of the COVID-19 vaccine
I have not received the COVID-19 vaccine

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) [14 remaining]
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
Pre-paid booklets will be provided on-site at Boot Camp. There is a limited number available.
$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
Glo-Germ Kit with Powder
Kit includes a small black-light and both Glo-Germ fluorescent powder.

A limited number will be available for purchase on-site.
$20.00 ea.
Add
Glo-Germ Kit with Lotion
Kit includes a small black-light and both Glo-Germ fluorescent lotion.

A limited number will be available for purchase on-site.
$20.00 ea.
Add
Glo-Germ Kit with Powder and Lotion
Kit includes a small black-light and both Glo-Germ fluorescent powder and lotion.

A limited number will be available for purchase on-site.
$30.00 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 March 10, 2021.

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.

Location Information

Participant Contact Information

Registration Information

Handout Material