2026 FGBMFA National Conference

Registration Form

Single Registration — $100 Family Registration — $125

Family = Parents and children under 18 living in the house

Personal Information

Email Address

First Name

Last Name

Name as it would appear on the badge

Spouse's Name as it would appear on the badge

Children's Names (under 18)

Address

Phone

Emergency Contact Name

Emergency Contact Phone

Meal Tickets

Item	Quantity	Amount
Registration Fee		$100.00
Leader's Reception (Thursday night) Single $50 / Family $60		$0.00
Business Luncheon Single $55 / Family $65		$0.00
Saturday Grand Banquet Single $55 / Family $65		$0.00
Total		$100.00

Payment Information

Credit Card Type

Card Number

Expiration (MM / YY)

Security Code

Billing Zip Code

Signature