Registrant's Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you using the MyCAA Benefit?

You will not be required to make a $100 deposit

Yes

No

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Payment, refund and cancellation policies *

By checking below and by submitting this form I agree to the following terms and conditions: There are no refunds except upon cancellation and a training is not rescheduled, the instructor, Amanda Dodson will issue a 100% refund. For overseas in person trainings, I may transfer my registration to another person with approval from Amanda Dodson and by paying a $50.00 transfer fee. I understand the course will be confirmed by the instructor in a timely manner based on training location. I understand if I make any plans prior to course confirmation by Amanda Dodson and the training is canceled, Amanda Dodson is not responsible for any expenses incurred. In the event of inclement weather, technical issues, travel concerns or other issues that make it impossible for Amanda Dodson to hold the training, a make-up date will be scheduled. Amanda Dodson is not responsible for any expenses incurred.

I Agree

* Training terms and conditions: By checking below and by submitting this form I agree to the following terms and conditions regarding the training: *

I understand that Amanda Dodson will share my name and contact information with the CAPPA office. I understand that Amanda Dodson may take pictures or video of the training that include me. I understand that these pictures or video may be used online or in print by Amanda Dodson or CAPPA for promotional purposes. I understand that quotes from my training evaluation may be used online or in print by Amanda Dodson or CAPPA for promotional purposes. I understand that I may not record (audio or visual) the training workshop. I may not photograph the PowerPoint slides, training materials, certificate of completion or any other intellectual property belonging to CAPPA or Amanda Dodson I understand that I may take photographs during the training only with the express consent of Amanda Dodson and the other participants in the workshop. I understand that I may not post any of the photographs on social media or email them without the express permission of Amanda Dodson and the other participants in the workshop. I understand that none of the photographs may be used for advertising purposes nor sold or distributed to any other party. I understand I may not reproduce, publish or distribute any of the materials in the training manual. I understand that I must attend all portions and days of the training. If I miss any portions of the training I will not receive a certification of training or contact hours. I understand I must be 18 years old to attend the training.

I Agree

Registrant's E-Signature *

First Name

Last Name

Date

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