"Please fill out the secure registration form below to register for the conference.
If you have questions, please call our conference coordinator at (804) 247-1655. Thank you."

To See Our Conference Brochure Click Here


 
"The Gluten Truth meets The Circle of Life" Conference November 3-6, 2011

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CONFERENCE ATTENDEE REGISTRATION FORM

On-Line Registration (by Credit Card - MasterCard or Visa)
If you prefer to register by phone, please call (804) 247-1655.

Special "Buddy" Discount Offer
Bring a Buddy and get 1 admission 50% off (equivalent to 25% of both registrations)
Note: Discount will be calculated at the time of credit card processing, not in calculation on this page.

Conference Fees


Full Conference Program & Meals (November 3 - 6, 2011): $269.00
 

Friday only Morning & Afternoon Lecture Program & Lunch (November 4, 2011): $92.00
 

Saturday only Program & Meals (November 5, 2011): $92.00)
 

Sunday only Program & Meal (November 6, 2011): $38.00
 
Additional Guest Ticket Fees
Thursday, November 3  Welcome Reception -
$15.00
Friday, November 4       Banquet - $25.00
Saturday, November 5  Banquet - $25.00
Note: By providing your e-mail, you grant IHI permission to contact you via e-mail regarding your registration and updates on the “The Gluten Truth meets The Circle of Life” Conference. None of the information provided in this form will be shared with any outside entity or organization; it will be kept securely for purposes relating only to the conference.

Please fill out the following information and click 'Submit' below.
Items listed with an asterisk are required inputs.

Fill out the following information and click 'Submit'.
Fill out the following information and click 'Submit'.

*First Name
*Last Name
Company
*Address
*City
*State   *Zip
*Phone Number
*Email
*Verify Email
*Registrant Category Other:  
*Number of Attendees Including Myself  
*Conference Cost  
Total Conference Registration
Additional Thursday Welcome Reception Tickets  
Cost of Reception Tickets
Additional Friday Banquet Tickets  
Cost of Friday Banquet Tickets
Additional Saturday Banquet/Concert Tickets  
Cost of Saturday Banquet/Concert Tickets

Grand Total
*Friday Night Banquet Special Needs Attendee One
None Vegetarian Kosher

(true need only please)

*Saturday Night Banquet Special Needs Attendee One
None Vegetarian Kosher

(true need only please)

If you are interested in participating in the Friday Night
Talent/Karoake Program, please list your desired involvement here (3-5 minute act/song)

Friday Night Banquet Extra Ticket Registration and Meal Special Needs:

I am participating in the buddy program  
Name of Buddy
Email Buddy
Phone Buddy
Friday Banquet Special Needs Buddy
None Vegetarian Kosher

(true need only please)

Name of Attendee Three
Email Attendee Three
Phone Attendee Three
Friday Banquet Special Needs Attendee Three
None Vegetarian Kosher

(true need only please)

Saturday Night Banquet/Concert Extra Ticket Registration and Meal Special Needs:

Name of Buddy
Email Buddy
Phone Buddy
Saturday Banquet Special Needs Buddy
None Vegetarian Kosher

(true need only please)

Name of Attendee Three
Email Attendee Three
Phone Attendee Three
Saturday Banquet Special Needs Attendee Three
None Vegetarian Kosher

(true need only please)


*Type of Card
Master Card
Visa
*Name On Credit Card
*Credit Card Billing Address is the Same as Registrant Address
Yes
No
If not please enter the billing address below
Billing Address
City
State   Zip
*Credit Card Number
*Expiration Date (Example MM/YY)
*Three Digit SSV Code

PLEASE NOTE: Registrations will not be processed without payment or if submitted with declined or invalid credit cards. If you register on-line, you will receive an immediate confirmation.

COURTESY NOTE: "The Gluten Truth meets The Circle of Life" Conference is a non-smoking conference. Also, out of respect for our chemically sensitive patrons, we ask that no perfume, cologne, hair spray or other perfumed products be worn at the conference. Thank you.

REFUND POLICY: Refunds (less a $50.00 processing fee) will be given to registrants who cancel by 5:00 p.m. on Friday, October 21, 2011. No refunds will be made after that time.
DISABILITY ARRANGEMENTS: If special arrangements are required for anyone with a disability, please contact us at (804) 247-1655 or email conference@intestinalhealth.org.
NOTE: You may transfer your registration to another person at any time.


Our Other Online Products and Services:
Six Sides of Service

"Enterolab" - Our Clinical Reference Laboratory Website

"Be the Circle" - The Musical Journey to Goodness Website

"The Organic Alternative" - An Organic SuperFood Solutions Website

To Purchase DVDs of Our 2006 and 2008 Health Conferences

"Get on a Mission of Nutrition" CD, DVD, School Curriculum

Dr. Fine's Music CD's

 


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