Registration Form
Fill out on-line then print and fax or mail
Institute on Creating Sustainable Environments for ChildrenSM
Kansas City, MO
June 10-11, 2010
Pre-Conference Day June 09, 2010

Name:
Organization/School:
Address:
City: State: Zip/Postal:
Phone: Fax:
E-mail:
Do you require any special accommodations?
Payment:
Amount enclosed:
June 10-11 Institute: $299 x =
June 09 Pre-Conference: $95 x =
      _________________________________
Total payable to WHLLG =

Please select one:

Check or money order enclosed payable to "White Hutchinson Leisure & Learning Group" for above amount.

Payment by VISA.

Payment by MasterCard.

(sorry, no AMEX)
Credit Card Number:
CVV: Expiration Date:
Name on Card: Amount Paid: US $
Signature: Date:

Check or money order for $304 for one-hour graduate credit payable to "National Louis University"
(sorry, no credit card payments)
Amount enclosed:
  • One-hour graduate credit
 $304 x =
      _________________________________
Total payable to NLU =
I prefer not to have my e-mail shared with other participants.
  1. Registration includes CD resource
  2. The Institute will be limited to 35 participants on a first come first serve basis.  Registration is based on date of receipt.
  3. Deadline for registration is May 25, 2010.
  4. Payment must be paid in US dollars via check, money order or credit card with registration or within 30 days of registration for payments coming from institutions, but not later than the registration deadline.  No registrations will be held if payment is not received by the registration deadline.
  5. There is a $50 cancellation fee.  Cancellations will not be refunded after May 15, 2010 registration deadline.

White Hutchinson reserves the right to cancel the Institute due to circumstances beyond its control including Acts of God, war, governmental restrictions, adverse weather, disasters, strikes, civil disorder, or curtailment of air travel and for insufficient registrations.

Event Location
The institute will be held at the Courtyard by Marriott Country Club Plaza, in Kansas City, MO, just a few blocks from the Country Club Plaza.  Established in 1923 by J.C. Nichols, the Plaza was designed architecturally after Seville, Spain.  The Plaza’s popularity and reputation has been recognized around the country. The entire 15-block district, with more than 150 shops and dozens of fine restaurants, makes The Country Club Plaza Kansas City’s premier shopping, dining and entertainment destination.

The institute’s special conference rate is $119 per night.  Reservations can be made directly with the Courtyard by Marriott at (816)-285-9755 no later than May 25, 2010.  When making reservations please identify yourself as a White Hutchinson Institute attendee.  Shuttle service is available by Super Shuttle from the KC airport to and from the hotel.

Send your completed registration form and payment to:

White Hutchinson Leisure & Learning Group, Inc.
4036 Baltimore Avenue
Kansas City, MO 64111

Credit card registrations should be faxed to 816.756-5058
(no phone-in registrations accepted)

If you have any questions, contact Vicki Stoecklin at:
Phone: 816.931-1040, Ext 102 (Central Daylight Time zone),
Fax: 816.756-5058, or
E-mail: vicki@whitehutchinson.com