The Get Permission Approach Registration Page

The Get Permission Approach to Anxious Eaters, Anxious Mealtimes Conference - at the DoubleTree by Hilton Portland, Th/Fri. November 2-3, 2023.

Pricing

EARLY REGISTRATION - UNTIL SATURDAY, SEPTEMBER 23, 2023
$419.00/Participant for 1-2 Participants
$389.00/Participant for 3+ Participants

STANDARD REGISTRATION - SUN. SEPT. 24 TO THURS. NOV. 2, 2023
$439.00/Participant for 1-2 Participants
$419.00/Participant for 3+ Participants

The Drop Down Menu at the bottom of the registration form will have the
correct pricing for the number of participants you are registering.

The Get Permission Approach Registration Form

1. Complete the form below with the BEST CONTACT INFORMATION. We ask this because some work emails do not allow our emails to be received. You will get important information via email. Phone numbers should be personal because we may need to reach you on the day of the event and you may not be at a work number. We will not text/call you for anything not related to the course.

2. Press submit for the form to be received.

3. Continue to the Payment Section. Either pay by credit card or complete the form to the left regarding how payment will be made.

For a group rate to apply you must register all participants on the same form and pay at the same time/in the same way (using credit card, check, or purchase order).

* Indicates required field

Name, Credentials, and Primary Address of each Participant: (please # and list each person if there are more than one registering together.) *

Primary (Personal) Email Address of each Participant: (please # and list each person as above) *

Primary (personal) Phone Number of each Participant: (please # and list each person as above) *

Terms and Agreements (please check all 5 boxes) *

I agree to the Attendance Policy: I agree that I am attending a Live Conference in Portland, Maine on November 2-3, 2023. In order to receive the full amount of continuing education credits, I must attend the course for the entire duration of each day (9:00 AM – 4:30 PM each day). Additionally, all attendees are required to complete an evaluation summary of the course at the end of the conference in order to receive their certificate of attendance. Leaving early or missing time during the conference may result in a reduction of the amount of continuing education credits the participant will be issued. Please make any travel arrangements to ensure that you do not arrive late or leave the conference early. I agree to the Cancellation Policy: I agree that I have read the Cancellation Policy in the Information Section under Policies completely and agree to the policy in full. If you have any questions please call Lisa Ottman at 207-286-5631. I agree to the Payment Policy: All registration payments must be made in full or have an approved payment arrangement/issued purchase order with Coastal Education Services prior to the start of the conference in order to participate. I agree as the Attendee that by registering and attending the conference, Coastal Education Services has permission to contact me (or the attendee) by phone, email or mail. This information will not be shared or sold to any outside organization, though it may be used to offer the attendee information and resources pertinent to the conference topic and program. At any time, I can opt out or unsubscribe by contacting Coastal Education Services. Furthermore, if I am acting as an agent for the purpose of registering an attendee, I am agreeing to notify the attendee(s) of this agreement, and am agreeing on their behalf, to receiving any and all communications by the host. I agree that by checking this box I am verifying that I am the person registering for the conference and it will act as my online signature. If we have more than one participant on our registration form, I accept that all information on the form is for the participants listed. Each participant will receive a confirmation with contact information for Coastal Education Services. Each participant is responsible for their own cancellation procedures if necessary.

Submit

Please be sure to hit "Submit" above for your registration form to be received. Then select the Method of Payment Below.
The credit card payment process is separate for your security.

Credit Card

1. BE SURE YOU HAVE CLICKED THE SUBMIT BUTTON ABOVE SO WE WILL RECEIVE YOUR REGISTRATION FORM.

2. Once you have submitted your registration form above, please select how many participants you will be paying for below. The discounted prices are already in the drop down menu as a total per participant.

3. 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.

4. Please revisit our website for more information. If you have questions please go to the "Contact Us" tab above.

If Paying with a Credit Card please use the "Buy Now" PayPal button below.

Check/Purchase Order

Complete if Paying with Check or Purchase Order
(Not necessary to complete if paying with a credit card)

How do you plan to pay if not by credit card?
Checks:
Payable to: Coastal Education Services and
Mailed to: P.O. Box 3064, Kennebunkport, ME 04046.

Purchase Orders:
The BUSINESS MUST INITIATE SENDING A PURCHASE ORDER IN ORDER FOR US TO SEND THEM AN INVOICE. Email the Purchase Order to coastaleducationservices@yahoo.com. An invoice will be emailed to the contact person.

* Indicates required field

How will payment be made? *

Personal Check Business Check Purchase Order

Name of Conference Participant(s) *

Contact Person for Payment if different than the Participant *

First

Last

Contact Person's Email *

Contact Person's Phone Number *