Central Division Meeting Logo Central Division Meeting September 10-12, 2010
On-line Registration Form
(Please be sure that fields marked with an asterisk * are filled in.
You can use the mouse or the TAB key to move from field to field.
When completely finished, please press the "Enter" key, or click on the "Continue..." button.) 		Central Division Meeting Logo

We are very sorry, but the on-line registrations have closed. Please contact Jeannine Mogan if you would like to attend the meeting.

Patroller Name*: (as you want it to appear on your badge)

 Home Patrol*:
(enter "none" if not affiliated.)
 Secondary Patrol:
(optional)

Please check this box if you are receiving an NSP Outstanding Award from the Central Division.
(NSP Central Division Outstanding Award recipient's dinner provided compliments of the Central Division.)
Patrol/Region/Division Office (optional):
 Region*: (enter "none" if not affiliated.)
Steet address (line 1)*:
 Steet address (line 2):
City*:
 State*:
 Zipcode*:
Phone*:
 E-mail:
Guest #1: (as you want it to appear on their badge)
 Guest #2: (as you want it to appear on their badge)
 

Meals (Please note any medically indicated dietary restrictions in the additional information space below.) 		Price Qty Total
  • Friday Night BBQ dinner (6:30pm)
    		•  $ 23    
  • Saturday Boxed lunch at Hyland Ski & Snowboard Area (avaliable 11:30am - 1:30pm)
        (Only for those taking classes at Hyland. Sorry, others are on your own.)
    		• $  7    
  • Saturday Awards Banquet: Banquet reservations will NOT be accepted after September 4 !
    		•
    • Boneless Short Rib
         		$ 50   n/a  
    • Pan Seared Chicken Marsala
         		$ 45   n/a  
    • Vegetarian Option
         		$ 45   n/a  
  • Sunday PR/PD Breakfast (for PRs or their designee only. Sorry, others are on your own.)
    		•    N/C     N/C

    Saturday Educational Opportunities
    at the Hilton Hotel
  • OEC Instructor Recertification (12:30 - 4:30pm)
    		•  $ 10    
  • Instructor Development (Sat: 12:30 - 4:30pm and Sun: 8:00am - noon)
    		•  $ 10    
  • A Day in the Life of a Flight Nurse (1:00 - 2:00pm)
    		•    N/C     N/C
  • Award Informational Session (1:30 - 2:30pm)
    		•    N/C     N/C
  • Olympic Team Doctor Presentation (2:30 - 3:30pm)
    		•    N/C     N/C
  • Yoga for Skiers (12:30 - 1:30pm)
    		•    N/C     N/C
  • Arcology: An introduction to movement analysis and lesson planning (1:00 - 3:00pm) new item
    		•    N/C     N/C

    Saturday Educational Opportunities
    at the Hyland Ski and Snowboard Area
  • Level 1 Avalanche for Rescue Personnel (Sat: 12:30 - 4:30pm and Sun: 8:00am - noon)
    		•  $ 25    
  • Mountain Travel & Rescue Awareness: Low Angle Rescue (12:30 - 4:30pm)
    		•  $ 10    
  • CPR Refresher (1:00 - 4:00pm)
    		•  $ 15    

    Friday Activities
  • Golf - 9 holes (10:00am - 3:00pm)
    		•  $ 28    
  • Golf cart
    		•  $ 10    
  • Motorcycle Tour (11:00am - 3:00pm)
    		•    N/C     N/C
  • Wine tour (12:30 - 4:30pm)
    		•  $ 30    

    Meeting/Logo Wear     Sorry, the mock turtleneck shirts can not be ordered after August 15th.
  • Long Sleeved Mock Turtleneck:
    (Click here to display a photo.)
    		•
    • Small
         		$ 25   n/a  
    • Medium
         		$ 25   n/a  
    • Large
         		$ 25   n/a  
    • XL
         		$ 25   n/a  
    • 2X
         		$ 28   n/a  
    • 3X
         		$ 30   n/a  

    Banquet dinner discount for Central Division Outstanding Award recipient         		 

    Registration Fee **         		$ 20  

    Additional late fee after August 15th (no exceptions)         		$ 10    

    Total Submitted:   $         		 

    ** Registration fee can be waived if you are attending ONLY the Saturday evening awards banquet and your registration confirmation sheet and payment are received by 8-15-2010.

    I would like to pay for this with a check, or credit card.

    Additional information you would like to include with your registration:

    We are very sorry, but the on-line registrations have closed. Please contact Jeannine Mogan if you would like to attend the meeting.

    We reserve the right to cancel any activities due to unforseen events or lack of participation.

    Refund policy: If you cancel 30 days or more before the meeting, you will be reimbursed 75% of the full amount; 15-30 days, 25%. There will be no refunds for cancellations 14 days or less before the meeting. Questions may be directed to Jeannine Mogan 952-846-4989 or JMogan@threeriversparkdistrict.org

    If you have any questions about this on-line registration form, or are having any difficulties using it, please contact Roger Petry at rpetry@d.umn.edu