Registration
Jackrabbit BOOST West Coast User Conference
Thursday, Nov 16 - Saturday, Nov 18, 2017
Orleans Conference Center - Las Vegas, NV
Please take the time to complete all questions carefully!
Classroom style training is three full days.
See online agenda for daily schedule
Conference Fee of $195 per person includes admission to ALL Sessions/Activities .
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Organization Contact
First Name:
*
Last Name:
*
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
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City:
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State/Prov:
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Postal Code:
*
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
(format=mm/dd/yyyy)
Individual Email Address:
*
Attending Day 1:
*
Attending Day 2:
*
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
(format=mm/dd/yyyy)
Individual Email Address:
*
Attending Day 1:
*
Attending Day 2:
*
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
(format=mm/dd/yyyy)
Individual Email Address:
*
Attending Day 1:
*
Attending Day 2:
*
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
(format=mm/dd/yyyy)
Individual Email Address:
*
Attending Day 1:
*
Attending Day 2:
*
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
(format=mm/dd/yyyy)
Individual Email Address:
*
Attending Day 1:
*
Attending Day 2:
*
Questions/Options:
What is your Organization/Business Name?
If you have a Promo Code please enter it here.
Business Type? Indicate primary focus: Dance, Swim, Diving, Cheer, Gymnastics, Music, Performing Arts, Language/Education, Misc Sports (Basketball, etc.). Used for Roundtable Industry assignments.
*
Do you have an active Jackrabbit account/database?
(This question is intended for new clients. We recommend you have your database setup and have some familiarity with Jackrabbit.)
Yes
No
If Yes, please list month and year your Organization / Business started using Jackrabbit.
How long have you personally been working with Jackrabbit?
As best as you can remember, please list all learning options you have experienced:
( e.g. Jumpstart Coach, Webinars, Videos, Help Center, Live Training)
Primary Attendee First/Last Name (you):
Job Title:
Email Address:
Started Using Jackrabbit:
2nd Attendee First/Last Name:
Job Title:
Email Address:
Started Using Jackrabbit:
3rd Attendee First/Last Name:
Job Title:
Email Address:
Started Using Jackrabbit:
4th Attendee First/Last Name:
Job Title:
Email Address:
Started Using Jackrabbit:
FREE Small Group Session - Would you like to participate in a small group meeting with a Jackrabbit staff member on Sat Nov 18 between 1:00pm-5:00pm? (You will be assigned an appt time 7 days prior)
Yes
No
If yes, will you be leaving Las Vegas well after the last session at 5:00pm?
Yes
No
List the topics you would like to discuss during the small group session:
FREE Jackrabbit Welcome & Networking Social: Number of Attendees Thursday, Nov 16th:
Confirm Number of Attendees ($195 per Attendee):
Total Fee (Number of Attendee(s) x $195 =
Additional Information:
Other Questions/Comments:
Credit Card Verification:
Card Number:
*
Visa
Mastercard
Amex
Discover
Name as it appears on card:
*
Nickname:
Card Expiration Month:
*
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Address Line 1:
Address Line 2:
City:
State/Prov:
Postal Code:
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