March 17 -18, 2011 Student Union University of
Nevada, Las Vegas
REGISTRATION FORM You are invited to join Family TIES of Nevada for a unique training opportunity for youth with special health care needs and disabilities, family members and professionals who serve them. Learn about the transition process and how health influences success in school, work and independent living. Fees (Breakfast/Lunch included) $75 Professionals $40 Youth and Family Members
How to Register
Mail or Fax Form and payment to: Family TIES of Nevada A limited number of scholarships available for youth and family 3100 members Mill Street #117 Reno, NV 89502 Call 1-866-326-8437 for details Fax: 775-323-2205 Register & make secured online payment at: http://familytiesnv.org/training/registration_form Call 1-866-326-8437 for direct assistance.
Payment Method (Check one) Please consider me for a scholarship Purchase Order # Check (payable to Family TIES of Nevada)
Complete one form for each attendee Participant Information Full Name:
Company/Title (If applicable): Address: CANCELLATION POLICY Substitutions may be made any time prior to the event. Cancellations received by email, fax or phone after March 10, 2011 are subject to an administration fee equal to 50% of the registration fee. No shows are non-refundable.
Home Phone: Special Dietary Needs:
Work Phone Vegetarian
Hotels Embassy Suites Hotel *** 4315 Swenson Street Las Vegas, NV 89119 (866) 813-5349
Comfort Inn Las Vegas ** 4350 Paradise Road Las Vegas, NV 89169" (702) 938-2000
Holiday Inn Las Vegas *** 4055 Palos Verdes Street Las Vegas, NV 89119 (702) 473-6400
Hyatt Place Las Vegas *** 4520 Paradise Road Las Vegas, NV 89109 (702) 369-3366
Hard Rock Hotel **** 4455 Paradise Road Las Vegas, NV 89109 (800) 473-7625
Terribles Hotel and Casino ** 4100 Paradise Road Las Vegas, NV 89109 (702) 733-7000
CANCELLATION POLICY Substitutions may be made any time prior to the event. Cancellations received by email, fax or phone after March 10, 2011 are subject to an administration fee equal to 50% of the registration fee. No shows are non-refundable.