Please note that all prices are in U.S dollars and inclusive of taxes.

PERSONAL INFORMATION Full Name: _______________________________________________________________________________________________

University/Organization:____________________________________________________________________________________

Preferred Mailing Address:__________________________________________________________________________________

City: ___________________________ State/Province: _________________________ Zip/Postal Code: ____________________

Country: _____________________ Telephone: (_______)_____________________ Fax: (________)_______________________

Email: ________________________________________________________________________

SPECIAL REQUIREMENTS Special Assistance: If you have a disability or require assistance to fully participate in the conference, please state the assistance required: Dietary Requirements: Please indicate any food allergies or any special dietary requirements. Note that the organizing committee may not be able to accommodate some meal requirements: Other requirements: Please indicate any other allergies, or special requirements we should be aware of:

Conference Registration Form Next Step Conference 2011

“Promoting Global Partnerships in Sport for Development” November 7th-13th, 2011,

The Cascadia Hotel and Conference Center Port of Spain, Trinidad, W.I

CONFERENCE REGISTRATION FEES The Next Step conference will be held November 9

th – 12

th and includes 3 days of interactive sessions along with a day trip to

Tobago. Registration for the conference is $300 USD inclusive of lunch and refreshments on the 9th, 10th, and 11th and return airfare to the island of Tobago on the 12

th.

Several special interest workshops will be held 2 days prior to the conference. These pre conference workshops will require additional registration.

PRE CONFERENCE REGISTRATION FEES

The Pre Conference Workshops will be held November 7th

– 8th

. Registration for the pre conference is $75 USD per day inclusive of lunch and refreshments and can be paid prior to the conference or on site. Indicate the pre-conference workshop you wish to attend. Note that the Kicking AIDS Out and Gerreiras workshops are by Invitation Only.

Next Step Community Coaching Education Symposium - (Tuesday 8th November, 2011) Long Term Social Development through Sport Workshop - (Tuesday 8th November, 2011) National Paralympic Committee Development - (Monday 7th & Tuesday 8th November, 2011) Guerreiras Project - By Invitation Only - (Tuesday 8th November, 2011) Kicking Aids Out! Curriculum Guidelines - By Invitation Only - (Monday 7th & Tuesday 8th November, 2011)

TRAVEL AND ACCOMMODATION Arrival Date: ______/_______/________ Arrival Time: ________ am/pm Flight No.:____________ DD MM YEAR Departure Date: ______/_______/________ Depart Time: ________ am/pm Flight No.: ____________ DD MM YEAR The official conference hotel is the Cascadia Hotel & Conference Centre: http://www.cascadiahotel.com All prices include taxes, complementary buffet breakfast and wireless high speed internet. Please indicate either a single or double room.

Single room - $120USD per night x _____ nights

Double room - $130USD per night x _____ nights Sharing with ______________________________________________ Cancellation Policy: Reservations must be cancelled 7 days prior to the original reservation date. Failure to do this, a one-night penalty will apply.

PAYMENT OPTIONS Conference Registration can be paid prior to the conference or on site. Total Payment Due: Conference Registration ______________USD

Pre-Conference Workshop ______________USD Accommodation ______________USD Total Payment ______________ USD

Please indicate your method of payment.

Cash

Certified Cheque – Cheques are to be in U.S funds and made out to: The Trinidad and Tobago Alliance for Sport and Physical Education

Master Card Visa

Card Number __________________ /__________________ /_________________ /________________

Expiry Date ____/_____

Cardholder’s name (please print) _________________________________________

Cardholder’s signature__________________________________________

Please email the completed registration form with payment to: Email: ttaspe@ttaspe.org For any other questions please feel free to contact The Trinidad and Tobago Alliance for Sport and Physical Education (TTASPE) Phone: +1-868-387-0411 or +1-868-387-0409 or email us Agreement of Terms and Conditions: I wish to register for the 2011 Next Step Conference and acknowledge the registration terms including the cancellation policy. Signature: _________________________________________________ Date: ______________________________