Name:
Relationship to FOP member:
Age (as of 08/2007) :
Address:
City:
State/Province:
Zip Code:
Country:
E-mail:
Telephone:
Fax:
Names of family members and friends attending: For name badge purposes, please list complete name.
Name:
Relationship to FOP member:
Age (as of 08/2007)
Name:
Relationship to FOP member:
Age (as of 08/2007)
Name:
Relationship to FOP member:
Age (as of 08/2007)
Name:
Relationship to FOP member:
Age (as of 08/2007)
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Relationship to FOP member:
Age (as of 08/2007)
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Relationship to FOP member:
Age (as of 08/2007)
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Relationship to FOP member:
Age (as of 08/2007)
Registration Fee
Each person attending the Symposium will be charged a registration fee. The registration fee includes all meals from Thursday evening snack to Sunday breakfast, symposium materials, resource center, workshops, clinics and entertainment. Send your registration form as soon as possible to reserve your place.
IFOPA Members Registration Fee:
$250 per person for first 3 people $350 per person for 4 th and 5 th people $550 per person for 6 or more people
Professionals Registration Fee: $400 per person
If you choose not to stay at the JW Marriott, you will be required to pay an off-site registration fee .
Off-site Registration Fee: $550 per person
Financial Assistance for Registration Fee
Financial assistance is based on family need and is on a first-come-first-served basis. There are limited funds available to provide this type of financial assistance.
For those that require financial assistance in order to attend, the following registration fee will be available:
Financial Assistance Registration Fee: $150.00 per person for first three people per family.
Hotel Accommodation
All guest rooms for the Symposium are at the JW Marriott in Orlando, Florida.
The symposium dates are Thursday night, August 16 through Sunday morning, August 19, 2007. Dr. Kaplan's Medical Education Clinic will be held on Monday, August 13; Tuesday, August 14; Wednesday, August 15; T hursday, August 16; Saturday, August 18; Sunday, August 19; and Monday, August 20. Special Care and Medical Research Clinics will also be held on certain days. Please reference the Medical Clinics Sign-Up Sheet for complete details and sign up for all clinics. Rooms can be reserved at the discounted IFOPA rate from Monday, August 13 through Monday, August 20.
IFOPA group rate at the JW Marriott: $159 per night (up to 2 adults & 2 children), Single (1 King Bed) / Double (2 Queen Beds)
Additional Adult(s) - $20 per person per night (over 18 years of age)
Please check date(s) you would like to reserve a room, indicate the number of room(s) needed per night and the number of additional adult(s) per room (if needed). Do not include the day you checkout.
Monday, August 13
Tuesday, August 14
Wednesday, August 15
Thursday, August 16
Friday, August 17
Saturday, August 18
Sunday, August 19
Monday, August 20
I request a roll-a-way bed (limited availability).
Dates needed:
I request a handicapped room with a roll in shower (limited availability).
I request a handicapped room with a tub and a grab bar (limited availability).
IFOPA Kids Care Program *Child care services not available for ages 0 to 4 years
Childcare will be available (ages 5 to 12 years) from Friday, August 17 th through Sunday morning, August 19 th at the below rates. Children with FOP will receive free childcare . Families will be responsible for the cost of additional children other than the child with FOP.
Hours: Friday and Saturday Full day: 8:30 am – 5:30 pm. Friday and Saturday Half day: 8:30 am – 1:00 pm or 12:30 pm – 5:30 pm. Sunday Only Half day: 8:30 am – 12:00 noon. Rates include lunch, gratuity and taxes.
IFOPA Kids Care Program:
$80 per full day for 1st child (without FOP), $75 per full day for 2+ children $50 per half day for 1 st child (without FOP), $45 per half day for 2+ children Medication will not be administered to children.
Kids Care costs will be paid directly to the hotel at time of check out. Sign up now!
Child(s) Name:
Age (as of 08/2007)
Friday
Saturday
Sunday
Child(s) Name:
Age (as of 08/2007)
Friday
Saturday
Sunday
Child(s) Name:
Age (as of 08/2007)
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Saturday
Sunday
Teen Center
A free teen center with limited supervision will be available for ages 13 to 19. List below the names of teens attending.
Name:
Age (as of 08/2007)
Day(s) needed:
Name:
Age (as of 08/2007)
Day(s) needed:
Name:
Age (as of 08/2007)
Day(s) needed:
Dietary/Special needs
I/We require soft food selections
# of people:
I/We require pureed foods
# of people:
I/We require vegetarian meals
# of people:
Specify any other special needs:
Register Now!
Symposium FAQ 