2021 ACPA OSM Conference: Attendee Registration Form

First Name: *

Last Name: *

Email: *

Company Name: *

Address: *

City: *

State/Province: *

ZIP/Postal Code: *

Country: *

Phone: *

Will you be staying at the group hotel? *

Yes

No

Date of arrival: *

Month

Day

Year

Date of departure: *

Month

Day

Year

Are you bringing a guest who will attend ONLY the social functions? *

Yes

No

Guest Name: *

Guest Email: *

Is guest at least 18 years old? *

Yes

No

Age of guest: *

Emergency Contact Name: *

Emergency Contact Phone: *

Emergency Contact Relationship: *

Welcome Reception Reservation (Friday 10/15): *

Attendee Only

Attendee and Guest

Not Attending

Dinner Reservation (Saturday 10/16): *

Attendee Only

Attendee and Guest

Not Attending

Please list any dietary restrictions:

There are six categories of attendee registration - please read each description carefully before you make a selection

Registrant Category:

Member Pumper Attendee $345: Concrete pumping company member in good standing with ACPA
Includes conference registration and materials for educational sessions (excludes Train the Trainer Workshop), admission to the Equipment Display and Pump Rodeo as well as meals for Saturday’s breakfast, lunch and dinner and Sunday morning breakfast.

Non-Member Pumper Attendee $690: Concrete pumping company not a member of ACPA
Includes conference registration and materials for educational sessions (excludes Train the Trainer Workshop), admission to the Equipment Display and Pump Rodeo as well as meals for Saturday’s breakfast, lunch and dinner and Sunday morning breakfast.

Member Pumper Attendee + Train the Trainer Workshop $495: Concrete pumping company member in good standing with ACPA who will be attending the conference AND the Train the Trainer Workshop
Includes conference registration and materials for educational sessions, Train the Trainer Workshop, admission to the Equipment Display and Pump Rodeo as well as meals for Saturday’s breakfast, lunch and dinner and Sunday breakfast and lunch.

Non-Member Pumper Attendee + Train the Trainer Workshop $850: Concrete pumping company not a member of ACPA who will be attending the conference AND the Train the Trainer Workshop
Includes conference registration and materials for educational sessions, Train the Trainer Workshop, admission to the Equipment Display and Pump Rodeo as well as meals for Saturday’s breakfast, lunch and dinner and Sunday breakfast and lunch.

Member Vendor Attendee $345: Manufacturer/Distributor Member who is exhibiting or sponsoring a portion of the conference
Includes conference registration and materials for educational sessions (excludes Train the Trainer Workshop), admission to the Equipment Display and Pump Rodeo as well as meals for Saturday’s breakfast, lunch and dinner and Sunday morning breakfast.

Non-Sponsoring Vendor Attendee $690: Member or non-member manufacturer/distributor not already exhibiting or sponsoring any part of the conference
Includes conference registration and materials for educational sessions (excludes Train the Trainer Workshop), admission to the Equipment Display and Pump Rodeo as well as meals for Saturday’s breakfast, lunch and dinner and Sunday morning breakfast.

Registrant Spouse/Guest Category:

Guest Add-On: The spouse or guest of a Member Registrant attending ONLY the social gatherings of the conference.
MUST be included with a full conference attendee registration.

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2021 ACPA OSM Conference: Attendee Registration Form

Please complete the form below to register for the