ICPA Seminar Registration Form

Individual Class Attendance Fees:

Category
ICPA Member
Non- Member
DC

US$329

US$379
DC - First/Second Year of Practice
Faculty DC
Non-Practicing DC
Spouse DC: when spouse is enrolled in the entire series
Student
US$279
US$379

 

There are three ICPA payment options for the entire series.

1- Pay-As-You Go

Get online once per month and register yourself for the class.
Be sure to do so before 10am eastern time on Friday the week of the seminar, as there is a late fee after that time.

2- Auto-Registration:

Streamline your registration process by choosing the convenient service of our Auto-Registration option. To be pre-registered for for every class in the location of your choice, select the Entire Series (Auto-Registration) option at checkout and agree to the Auto-Registration Terms below. Your card will automatically be charged the Monday before each scheduled weekend. Make up any missed classes at any of our locations (MN and Dallas excluded). This service is avaialble to ICPA auto-renewal members.

3- ICPA Member Pay-In-Full:

Streamline your registration process and save the most by choosing our Pay-In-Full option. To be pre-registered for every class in the location of your choice, select the Entire Series (Pay-In-Full) option at checkout and agree to the Pay-In-Full Terms below. Make up any missed classes at any of our locations (MN and Dallas excluded). This service is available to ICPA auto-renewal members.

 

Category
Pay-In-Full (PIF)
DC

Total PIF Investment: US$4,464
Save US$800 off the entire series price of US$5,264

DC - First/Second Year of Practice
Faculty DC
Non-Practicing DC
Spouse DC: when spouse is enrolled in the entire series
Student
Total PIF Investment: US$3,664
Save US$800 off the entire series price of US$4,464

 

* - Required information

*Please provide office information if you are joining ICPA as a DC member. This information will go in the online directory.

Contact Information

* First Name:
* Last Name:
Suffix:
Office Name:
* Office or Primary Address:
Office Address (continued):
* City:
* State / Province:
* Zip / Postal Code:
* Country:
* Office or Primary Phone Number:
* Cell Phone Number:

Your cell phone will be used only for an emergency contact, such as a seminar cancellation, and will not appear on your directory listing.

Fax Number:
Web Page Address:



* DC or Student:
* Chiropractic College:
Trimester/Quarter:
* Date of Graduation: Month: Year:
Change of Address?: Yes -
Change of Name?: Yes - Old Name:


ICPA Membership Information



Unsure if you are a member or not? Click here to check your membership status.
(To find out when your ICPA membership expires, please click on your name in blue.)

NOTE: ICPA auto-renewal membership is required to receive optional Webster Certification.
* Current ICPA Member:

Be Sustainably Green with Automatic Renewal and SAVE US$50 on your membership

Yes, I want my membership to be automatically renewed -

By checking the box above, I give the ICPA permission to charge my card annually upon my membership expiration. By doing so, I will save US$50 off the above listed prices. If I decide to cancel my membership auto-renewal, I will contact the membership department via e-mail and cancel in writing and my dues will be prorated.

Click here if you are joining as a Married Couple


Seminar Information



Directions for Payment Options:

Pay-In-Full (PIF): To be pre-registered for every class in the location of your choice, select the Entire Series (Pay-In-Full) option at checkout and agree to the Pay-In-Full Terms below. Please select your location and choose the first weekend of the seminar series under Seminar Month/ Seminar Date. Your credit card will be charged the entire amount the Monday before the first scheduled seminar weekend.

Auto-Registration (Auto-Reg): To be pre-registered for every class in the location of your choice,select the Entire Series (Auto-Registration) option at checkout and agree to the Auto-Registration Terms below. Please select your location and choose the first weekend of the seminar series under Seminar Month/Seminar Date. Then choose the appropriate Per Module payment option under Seminar Cost.



Registration

* Course (or Entire Series):
The ONLINE Family Nutrition class is only available on the dates shown in the schedule.
Pay-In-Full and Auto-Registration will register you for the entire ICPA seminar series in the selected city.
* Seminar Location:
* Seminar Month: *Seminar Date:
* Seminar Cost:
Are you bringing a CA or Guest (Non-DC)?

Classes where you can bring a CA or guest are:
Dr. Ohm (Saturday afternoon only)
Dr. Marini
Dr. Carrino
Dr. Hall
Dr. Schaefer
Dr. Kevorkian

How did you hear about the seminar:

How did you hear about the seminar? Please check all that applies:

Chiropractic Association

Facebook

LinkedIN

Twitter

A Friend

ICPA Postcard

CE Cruncher

PLANET Chiropractic

Dynamic Chiropractic

 

Terms and Agreements



All attendees must read and agree to the ICPA Seminar Terms & ICPA Adjusting Technique Release Form

I confirm that I read and I agree to the ICPA Seminar Terms 
*  I confirm that I read and I agree to the ICPA Seminar Terms.

I confirm that I read and I agree to the ICPA Adjusting Technique Release Form
*  I confirm that I read and I agree to the ICPA Adjusting Technique Release Form

Perinatal Care Class with Optional Webster Technique Certification - US$45 fee additional for certification paid at seminar. This is a stand-alone seminar; enrollment in the Pediatric Certification program is not necessary.  ICPA auto-renewal membership is required to receive Webster Certification. Join above in the "ICPA Membership Information" section of the form.


Pay-In-Full (PIF) and Auto-Registration Must Read and Agree To The Following Appropriate Term To Participate.

  • I confirm that I read and I agree to the Student PIF/Auto-Registration Terms
     I confirm that I read and I agree to the ICPA Student PIF/Auto-Registration Terms

    PIF/Auto-Registration Automatic Membership Renewal Notice:
    To make this most convenient for you and to comply with the PIF/Auto-Registration Terms, you are being signed up for automatic ICPA membership renewal with your seminar payment program. 



Application Fees for Certification vary depending on location, length of course, sponsor etc. Please refer to website for requested location and fee. Registration charges will be processed up to two weeks prior to date of class. Cancellations are subject to penalty according to the discretion of the ICPA.

Registrations received after 10am EST the Friday prior to the seminar will be charged a US$25 late fee.

The day you register, you will receive a registration e-mail confirmation at 9 PM EST. If you do not receive this e-mail confirmation, it is possible the e-mail was sent to your junk mail or your registration did not go through. On Monday, the week of the class, your credit card will be charged. That evening, you will receive an e-mail with a link to the notes. If you do not receive either of these e-mails, please contact: seminars@icpa4kids.com to have them resent.

All fees are in US Funds.

Refund Policy