Join us on Sunday April 30th & May 1st! Please complete the form below to register for the conference. All fees must be paid online via Credit Card. If you wish to make arrangements to pay via check or voucher please contact the FTNYS office at 518.432.0333 x 10. How many people are you registering? * 1 2 3 4 5 6 7 8 9 10 Fill in your registration information on this page. You will be able to enter the registration information for additional people after you complete this page and click "Continue". 2023 Annual Conference Registrant Information First Name * Last Name * Email * County * - select County - Albany Allegany Bronx Broome Cattaraugus Cayuga Chautauqua Chemung Chenango Clinton Columbia Cortland Delaware Dutchess Erie Essex Franklin Fulton Genesee Greene Hamilton Herkimer Jefferson Kings Lewis Livingston Madison Monroe Montgomery Nassau New York Niagara Oneida Onondaga Ontario Orange Orleans Oswego Otsego Putnam Queens Rensselaer Richmond Rockland St. Lawrence Saratoga Schenectady Schohaire Schuyler Seneca Steuben Suffolk Sullivan Tioga Tompkins Ulster Warren Washington Wayne Westchester Wyoming Yates Zip Code * Race/Ethnicity African American Asian/Pacific Islander European/Caucasian Hispanic/Latin Native American Another not listed Mutiracial Military Status - select Military Status - Active Military Military Veteran Family Non-Military Do you identify as a youth, parent, professional or other? * Youth Parent Parent of a child receiving services Professional Other Dietary Restrictions Gluten FreeKosherVeganVegetarianOther (Please specify in special requests field below)None Other (Dietary Restrictions Not Listed) Special Requests/Accommodations I give permission to Families Together to photograph and/or videotape this registered attendee and to use his or her image in photographs, video, and/or film for the purpose of promoting the mission, activities, and programs of Families Together. I understand that this registered attendee and his/her parent/guardian/legal authority is not entitled to any compensation or rights in these materials, and I release Families Together from any liability for the use of this registered attendee's image for the above stated purpose. Please check. Video/Photo Release * I agree Event Fee(s) If you have a discount code, enter it here Apply Registration Fee * Adult: Sunday Only - $ 150.00 Youth (12-25): Sunday Only - $ 150.00 Adult Two Days - $ 290.00 Youth Two Days - $ 225.00 Adult One Day - Monday - $ 150.00 Youth One Day - Monday - $ 150.00 Total for this participant Credit Card Card Type - select - Visa MasterCard Amex Discover Card Number * Security Code * Expiration Date * -month- Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec -year- 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 Billing Name and Address Billing First Name * Billing Middle Name Billing Last Name * Street Address * City * Country * - select - United States State/Province * - select State/Province - Alabama Alaska American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Postal Code * Review
