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Participant Registration

Regional Membership
Banquet ticket $50.00

Additional Guest(s)

In the space below please list the names for your guest(s), if they are going to have the meal plan ($160), attending the banquet ($50), dietary accommodations and special requirements.


Conference Registration       $175.00

Regional Membership(s)     +  $ (10-55)

Banquet Ticket                     + $50.00

Guest meal plan(s)               + $160.00 x number of guests

Guest banquet tickets         + $##.00 x number of guests

After submission of this form you will be sent an email including WAC2019's Liability Release form, acknowledgement of IPS Code of Conduct, and an invoice detailing your registration and allowing you to pay via PayPal or check.

Thanks for submitting!

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