This document is a registration form for the Eastern Sierra Child Development Conference taking place on October 29, 2011. Attendees can choose three workshop sessions to attend and must submit their registration by October 5 to be guaranteed a spot. The registration fee is $60 for non-members and $55 for members, which covers breakfast, lunch, and snacks. No on-site registration or purchase orders will be accepted.

1. Eastern Sierra Child Development Conference<br />Saturday October 29, 2011<br />8:30 a.m.—4:30 p.m.<br />Kerr McGee Center<br />Please type or print clearly using black or blue ink.<br />Name:__________________________________________NAEYC Membership #_________________<br />Address:____________________________________________________________________________<br />City:_____________________State:__________________Zip Code:____________________________<br />Contact Phone Number:____________________Email:_____________________________________<br />Name of Center, Family Child Care, Agency or Organization:___________________________________<br />WORKSHOP INFORMATION<br />Workshop placement is first come, first served so mail your registration early! Please register early and fill in three choices for each session. You will not receive confirmation before the conference. Conference registration packets and workshop placement will be available at the registration tables the day of the conference. Information regarding Professional Growth will be available the day of the conference. <br /> Workshop Name Number<br />SESSION 1 (1st choice)________________________________________ ____________ <br /> (2nd choice)_______________________________________ ____________<br /> (3rd choice)_______________________________________ ____________<br />SESSION 2 (1st choice)________________________________________ ____________<br /> (2nd choice)_______________________________________ ____________ <br /> (3rd choice)________________________________________ ____________<br />SESSION 3 All participants will be able to join Lisa Murphy for her workshop Fizzle, Bubble, Pop and <br /> Wow! during Session 3. <br />Registration Information:<br />Registration fee is $60.00 for non-AEYC members and $55 for AEYC members. All registrations must be postmarked by October 5, 2011.<br />All registrations must be received by October 7, 2011.<br />Continental breakfast, lunch and afternoon snack are included with the conference fee.<br />Pre-registration is required. There will be no on-site registrations.<br />Sorry we are unable to accept purchase orders.<br />Mail completed registration form along with your check or money order payable to Eastern Sierra AEYC to:<br /> Eastern Sierra Child Development Conference Committee<br /> P.O. Box 1293<br /> Ridgecrest, CA 93556 <br />Registrations will not be processed until payment has been received.<br />Registrations are transferable. If you are registered, but are unable to attend, you may substitute <br />someone in your place. Sorry, there will be no refunds.<br />Verification of professional growth hours will be available.<br />For more information contact Kristina French at 760-499-1770.<br />