Online Secure Registration Form                                 
WABC 9th International Conference Oct. 21-23, 2007  St Petersburg, Florida USA

 First Name      Last Name
 participating inFull Conference   participating by the day: Sun. Oct. 21   Mon. Oct. 22   Tues. Oct. 23
        enter this individual's total fee   be it as a Member or non-member becoming a Member

 First Name      Last Name
 participating inFull Conference   participating by the day: Sun. Oct. 21   Mon. Oct. 22   Tues. Oct. 23
        enter this individual's total fee

 First Name      Last Name
 participating inFull Conference   participating by the day: Sun. Oct. 21   Mon. Oct. 22   Tues. Oct. 23
        enter this individual's total fee

 First Name      Last Name
 participating inFull Conference   participating by the day: Sun. Oct. 21   Mon. Oct. 22   Tues. Oct. 23  
        enter this individual's total fee

 Guest for lunches or receptions - Name and all that they will attend
         Name                    -                    (Sun. luncheon, Sun. dinner, Mon. reception, Tues. luncheon)
 
     enter this guest's total fee

 Guest for lunches or receptions - Name & all that they will attend
         Name                    -                    (Sun. luncheon, Sun. dinner, Mon. reception, Tues. luncheon)
 
     enter this guest's total fee

 Organization Name

 City    State or Region

 Country 

 Email

 Fax Telephone

 Website

 Payment: Mastercard , Visa or US bank check in US funds.

Credit or Debit Card by Master Card or Visa only       

Mailing a check drawn on a United States bank in United States funds -  
      if residing outside of the United States - your bank can arrange this.
      WABC PO Box 10596, St Petersburg, FL 33733 USA     
      Fax number 01 727 230-7489  Phone number 01 727 804-3399
     if you need further information, email WABC at info@WABCswim.com

Card Holder Name as it appears on card

16-digit Card Number - no spaces  (double check the numbers entered)

Expiration Date   month / year

Last 3-digits of the number series on the back of the card (CVV2 security code) 

If and only if card holder resides in the a U.S.A., the Card Holder's card street number & street address
and  card billing zip / postal code

If not currently a WABC member, you must include  (see fee schedule below)
$195 for program membership passport  $95 U.S. for individual membership passport

Amount to be charged to card or sent by check (total for all participants - guests above)  

please enter my name and contact information onto the “Roommate Finder” list shared
      only among others who are considering a roommate to share room expense and cut cost.

Is this your 1^st WABC conference - St Petersburg?     
Attended:  Tokyo 1990    Los Angeles 1993    Melbourne 1995    Oaxaca 1997
                 Toulouse 1999    Buenos Aires 2001     Hawaii 2003    Malmo 2005   

Arriving St Petersburg date         
Departing St Petersburg date   

Cancellations/Transfers:  All cancellations will be charged a $50 non-refundable administrative fee. 
No refunds will be provided for cancellations received after Friday, October 5, 2003 - transfer of
registration fee are fine - email WABC for details and conditions. To transfer registration send
request to WABC office info@WABCswim.com as soon as possible  

Additional information that you would like to share or questions with your registration:
 

Questions? email WABC info@WABCswim.com

This form is sent to WABC for processing of registration and payment.
If you have changes, email WABC at info@WABCswim.com
You'll receive an email conformation of this registration, if you do not in 24 hours,
email WABC info@WABCswim.com