NaFFAA Membership Application

2019 National Empowerment Conference
08/15/2019 08:00 AM - 08/19/2019 12:00 PM ET

Location

City of Carson Community Center
801 East Carson Street
Carson, CA 90745
United States of America (the)

NaFFAA National Empowerment Conference 2019 Online Registration Form

Make it Count:Transforming Mindsets for 2020 and Beyond
(page 1 of 4)

Basic Information

Please enter your demographic information so we may send your relevent updates about your local community. NaFFAA is committed to protecting your privacy. We use NEON CRM and PayPal Payments Pro to process your secure online payments.

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NaFFAA Information

Please fill out NaFFAA specific information here. If you have more than one position or are also representing another organization, please specify here. 
Click here to find out your NaFFAA region. 


 

Additional Information

Please help us get a better understanding of our membership by filling out the following information. NaFFAA will not share or sell this information and is only for internal use to better understand our community. 

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Login Information

Manage your NaFFAA account (i.e., change email settings, view donation history, renew membership, etc.), please create a login name and password below. Your password must be at least eight characters long, and contain at least one number.


 

Regional Confirmation

Waiver Statement:

I, hereinafter the Participant, understand that all online ticket sales are non-refundable. 

The Participant, together with my heirs, executors, administrators, and assigns, hereby release, waive, and forever discharge NaFFAA, Carson Community Center, and/or their respective past and present employees, representatives, agents, officers, directors, affiliates, members, successors, assigns, and volunteers, as well as the Conference’s volunteers and sponsors (the “Released Parties”), from and against any and all liability, claims, demands, actions, or causes of action of any and every kind and character which they had, have, or may have in the future, including but not limited to all injuries, damages, or losses, which arise from or as a result of the Participant’s attendance at the Conference or participation in any associated activities. The Participant hereby further agrees to hold harmless the said Released Parties, of and from any and all liability, claims, demands, actions, rights of action, loss, damage, including attorney’s fees and costs, which arise from or as a result of the Participant’s attendance at the Conference or participation in any associated activities. 

Photo and Written Material Release: In further consideration for allowing the Participant to attend and participate in the Conference, the Participant does hereby give the Released Parties permission to capture and/or record the Participant’s name, image, likeness, persona, photograph, or voice, in any media and/or technology now known or later developed. Such use of your name, image, likeness, persona, photograph, or voice can be used throughout the world for educational, commercial, trade, or any other lawful purpose, including current and future promotional materials. 

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