43rd National Adapted Physical Education Conference:

Promoting Physical Activity for All

November 13-15, 2014

Hyatt at San Francisco Airport – Burlingame, CA

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Address
City State Zip
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Employer/College

CAHPERD Membership ID# & expiration date – required to register at member rate:

Early Registration Rates**Early Registration postmark deadline date is 10/17/14.
Please check appropriate boxes.
A. Professional CAHPERD Member$185.00
B. Professional Non-CAHPERD Member*$220.00
C. Speaker (must have received letter)$85.00
D. Retired CAHPERD Member$90.00
E. Student CAHPERD Member$90.00
F. Student Non-CAHPERD Member$100.00
NOTE: If registering in categories above, Meals are included. Please be sure to check boxes in the column on the right to indicate which meals you will be attending. Meal tickets will not be guaranteed if boxes are not checked.
NOTE:Meals and Social can be purchased by checking selections below. Space is limited for Thursday Opening Session and Social! Book early!
G. Syllabus on-lineComplimentary
H. Meals (Guests) $85.00
I. Guest/ Spouse Thursday Social $25.00
Please be sure to check boxes in the column to the right to indicate which meals you will be attending. Meal tickets will not be guaranteed if boxes are not checked.
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Registration Total$

Early Registration postmark deadline date is 10/17/14.
HOTEL INFORMATION:
Hyatt Regency San Francisco
Group rate available until October 25, 2014.
Subject to Availability.
Phone: (650) 347-1234 / Check Meal Functions you will attend:
Thursday Social
Saturday Awards Luncheon/ General Session
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Payment Option:
Made payable to CAHPERD
By check, credit card or purchase order
If needed, fill in credit card information below
Credit Card #
Credit Card Expiration Date
Signature (required only for credit card transactions)
Mail Early Registration with Payment to:
CAHPERD
1501 El Camino Avenue, Suite 3
Sacramento, CA 95815-2748
Early Registration postmark deadline date is 10/17/14**
After 10/17/14 registration is only available on-site.
Special Need Accommodations
Check if reasonable special need accommodations are requested and describe:
(Must be requested by 10/17/14 to guarantee service.
After 10/17/14 registration is only available on-site.

*CAHPERD member registration rates may be obtained for non-members if CAHPERD membership is paid at the time of conference registration. Membership applications are available at CAHPERD by telephone, (916) 922-3596 or at

**All forms for Early Registration must be submitted with payment (check or Visa/MasterCard) and postmarked or faxed by 10/17/14. Registrations by Visa/MasterCard or PO may be sent by fax to (916)922-0133 and mustbereceived by10/17/14.If you are unable to meet this postmarked deadline, registration is only available on-site. No exceptions. On-site registration rates will be $60 higher in all categories, EXCEPT Retired and Student. On-site registration does NOT guarantee meals or social.