Registration Page - Vision & Child Development

To Register for the Conference

1) Complete the Registration Form below and press "Submit" before selecting the method of payment.
2) If paying with credit card, use the "Buy Now" button below the registration form on the bottom left side.
3) If paying with a check or purchase order, please complete the form on the bottom right side. Purchase Orders are still being accepted up until the conference date.

Wednesday, November 13, 2019 - Portland, ME
Thursday, November 14, 2019 - Manchester, NH

Fill out the form below and select your date to attend at the bottom of it. Then press submit. Payment options are below the registration form.

* Indicates required field

Name and Credentials of each participant attending. (please # and list each person) *

Email address of each Participant: (please # and list each person as above) *

Phone number of each Participant: (please # and list each person as above) *

Billing Name/Organization (Line 1) and Street Address (Line 2) *

Line 1

Line 2

City

State

Zip Code

Country

Select one of the locations/day you will attend then check both of the terms of agreement below. *

I will attend in Portland, ME on Wed. Nov. 13, 2019 I will attend in Manchester, NH on Thurs. Nov. 14, 2019 I agree to the Cancellation and Substitution Policy: Substitutions may be made at any time. All requests for cancellations must be received in writing to [email protected] no later than October 12, 2019 to receive a refund minus a $25. processing fee. If written cancellation is received October 13, 2019 or later, a credit voucher for a future seminar sponsored by Coastal Education Services will be issued. Credit vouchers are transferable and do not expire. Returned checks will be charged a $35.00 fee. If a registration is substituted for another attendee, a different date for the same conference (day before or day after), or a credit for the amount paid may be given for use toward a future conference with Coastal Education Services. The latest a registrant may request a credit towards a future conference is 24 hours prior to the start of their scheduled conference. Otherwise a substitution may be made until the start of the conference. If no substitution is made on time or an attendee is a "no show", they will not be refunded or receive a credit. In the event the program must be cancelled due to illness, fire, strikes, war, acts of God, terrorism or other causes that would prevent the event from taking place, the provider will attempt to reschedule the event. If the event is unable to be rescheduled, the provider will refund all tuition fees paid. Costs incurred for non-refundable travel arrangements or other related individual expenses will not be refunded. I agree to the Payment Policy: Purchase Orders will be accepted as a form of payment for the conference. Please have the person handling the Purchase Order contact Coastal Education Services at [email protected] and complete the form below. All other participants need to pay in full by the date or have a payment arrangement made prior to the conference date.

Submit

Once you have submitted your registration form above, please select how many participants you will be paying for below. When you click the "BUY NOW" button below, you will be redirected to our secure sales merchant of PayPal and will not be able to connect back to our website. This is a security procedure. Please revisit our website and if you have any questions, you may submit them by completing a form under the "Contact" tab at the top of the pages or call us at 207-286-5631.

If you are paying with a Check/Purchase Order, please complete information below so we can match a form of payment with your registration.

We will confirm the receipt of your registration and/or payment within 48 hours of your sending it.

Complete below after submitting the Registration Form above
if Paying with a Check/Purchase Order
for the Vision & Child Development Conference

* Indicates required field

How do you plan to pay if not by credit card? Checks may be made payable to Coastal Education Services and Mailed to P.O. Box 3064, Kennebunkport, ME 04046. Purchase Orders may be emailed to [email protected]. *

Personal Check Business Check Purchase Order

Names of Registrant(s) *

Contact Person's Email *

Contact Person's Name *

First

Last

Submit

Complete below after submitting the Registration Form above if ​Paying with a ​Check/Purchase Order for the Vision & Child Development Conference

Complete below after submitting the Registration Form above
if Paying with a Check/Purchase Order
for the Vision & Child Development Conference