Registration
Jackrabbit Beyond the Basics Training - Edison
Friday, October 18th from 9:00 am - 4:30 pm
Location:
Hilton Garden Inn - Edison Raritan Center
50 Raritan Center Parkway
Edison, NJ 08837
Important: Please answer ALL questions under Questions/Options.
Please list your organization's main contact in the Contact section and list EVERY ATTENDEE (including yourself) and his/her individual/unique email address in the STUDENT SECTION. You may leave the gender and birthdate field blank for every attendee.
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:
*
City:
*
State/Prov:
*
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:
Organization/ Business Name?
*
Business Type? Indicate primary focus: Dance, Swim, Diving, Cheer, Gymnastics, Music, Performing Arts, Language/Education, Misc Sports (Basketball, etc.).
*
Please list month and year your Organization / Business started using Jackrabbit.
*
What knowledge do you hope to gain from this training?
Please enter the name of EACH PERSON (including yourself) that will be attending and confirm the total number of attendees from your organization.
*
Promotion code (if any)
Additional Information:
$99 Fee per Attendee
(Show-Hide Details)
I understand there is a $99 fee per attendee.
I've read the above and agree.
Payment
(Show-Hide Details)
I understand the total amount due will be processed within 48 business hours.
I've read the above and agree.
Cancellation/Refund Policy
(Show-Hide Details)
All cancellations and/or request for refunds or credits must be submitted in writing to education@jackrabbittech.com. Full refund or credit towards another training will be given if cancelled at least 30 days before the training. NO refund for No-Shows or if cancelled within 14 days of training.
I've read the above and agree.
Photo/Image/Likeness Release
(Show-Hide Details)
I understand by attending a Jackrabbit sanctioned event, including social times outside of scheduled classroom training, my image and/or likeness may be used in promotional materials.
I've read the above and agree.
Jackrabbit Database
(Show-Hide Details)
I understand that I should have a (free trial or client) Jackrabbit database prior to the training dates.
I've read the above and agree.
Internet and Laptop Use
(Show-Hide Details)
I understand internet access will be provided, but I must bring my own laptop.
I've read the above and agree.
Enter your Full Name:
*
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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Exp Year:
*
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Address Line 1:
Address Line 2:
City:
State/Prov:
Postal Code:
*
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