West Virginia Recreation and Parks Association Conference

40th Annual West Virginia Recreation and Parks Association Conference October 2 – 4, 2012

BLACKWATERS CONFERENCE CENTER, DAVIS WV

NAME (One name per form) ______

AGENCY / ORGANIZATION ______

ADDRESS ______

CITY, STATE, ZIP ______

PHONE W ______C ______EMAIL ______

REGISTRATION PROFESSIONAL FULL PACKAGE Includes Keynote Speaker, Welcome Dinner, Educational Sessions, Exhibitor Pass, and More ...... Please circle appropriate item. Prior to 09/1/12 $125.00 After 09/15/12 $150.00

STUDENT and NEW MEMBER PACKAGE Includes Keynote Speaker, Welcome Dinner, Educational Sessions, Exhibitor Pass, and More ...... Please circle appropriate item. Prior to 09/01/12 $50.00 After 09/15/12 $65.00

DAILY REGISTRATION *TUESDAY, 10/02/12 $75.00 *WEDNESDAY, 10/03/12 $100.00 *THURSDAY, 10/04/12 $75.00 Please circle appropriate item.

West Virginia Recreation and Parks Association Annual Membership expires November 1.

Please circle appropriate items. Student Membership: $10.00 CEU Credits: $20.00 Professional Membership: $35.00 GOLF Workshop: $50.00 Board /Commission Membership: $50.00 Extra Keynote Dinner: $30.00 Agency Membership: $250.00 Extra Banquet Lunch: $30.00

*Cancellation POLICY – Registration fee / exhibitor fees, minus $25. There will be refunded if cancellation notice is not received prior to 9/01/12. NO Refunds after 9/15/12. * (Professional Membership fee is not part of the Registration Fee)

Checks Payable to: WVRPA Ask for WVRPA Rates Mail to: Don Burton Blackwater Fall State Park Benedum Civic Center P.O. Box Drawer 490 164 West Main St. Davis, WV 26260 Bridgeport, WV 26330 304-259-5216 304-842-8240 www.WVRPA.ORG [email protected] 1-800-CALL WVA