12 State Vision Midwest Conference

October 22 thru 24, 2010
Exhibition Hall at the Alliant Energy Center
1919 Alliant Energy Center Way, Madison, WI 53713

Conference Registration Form

Contact Information

Special Activities

Check all activities you would like to participate in and we will provide you with more information. The Vision Midwest Conference will try to accommodate requests, but does not guarantee activity scheduling or placement.

Tactile Art Museum Tour. Transportation provided. Please indicate first and second choice of times.

(prepare to leave by 8:45 AM)
(prepare to leave by 1 PM)
(prepare to leave by 1 PM)

Brewery Tour (Friday and Saturday evening - must be 21 years old or older - additional $3 brewery fee that includes samples required at the door - for $5 busing see below)

Drink and Hors d’oeuvres Fundraiser at Yahara Bay Distillers. Friday, Oct 22, 7:30 PM - 9 PM, must be 21 years old or older, $25 fee (transportation from hotels provided, free food and some drinks/samples free, entertainment and a cash bar).

(be prepared to leave by 7 PM)

GPS Hunt.
If you're bringing your own GPS device, please enter the :
Please indicate first and second choice of days:

Running Club at UW Madison. 15K and 3x5K Relay Race ($13 fee required by Club)

Braille Make-A-Shape Book

Home Brewing/Distillery Tour

Tandem Bicycling

(rain date SUNDAY, October 24)
Tandem Bicycling Information

Tell us if you need a tandem bicycle provided and if you need a tandem partner.

Reasonable Accommodations/Special Needs

The conference will attempt to accommodate needs if registration is received by 9/15/10. Braille and Large Print Programs will be available—checking those needs below helps us to provide enough copies. Please check all that apply.

(a program will also be available online)
(a program will also be available online)
- You must provide your phone number or email address in the contact information above and we will contact you.
-
 
Conference Fees

Basic Conference Fees - check only one of the following three and put total at bottom.

Bowling Details

If you selected bowling above, please complete the following:

Choose squad time:

Additional Conference Activities

Check all that apply and total below.

Total & Submit

(Add fees from Conference Fees and Additional Conference Activities, from directly above)

Please Note: There are no reduced companion registration fees and no refunds will be made. Your registration receipt will come via email or mail and your registration card will be provided for you with proof of receipt or with legal identification at the conference Registration table. All Vision Midwest Conference attendees agree to all terms, rules and conditions of the Vision Midwest Conference and its facilities, including and not limited to the Exhibition Hall at the Alliant Energy Center, and are bound by all applicable city, county, state and federal laws.