Registration Proof of VaccinationAAM Richmond 2022 requires proof of vaccination against the COVID-19 virus. Please provide a copy of your vaccination record to the Registrar either on this form, from our vaccine verification page, or by email, or post (see below). If you are unable to receive the vaccination, we require proof of a negative COVID-19 test within 72 hours of the beginning of the conference.Karen Harris, Registrar 907 Yucca Lane North Chesterfield, VA 23236 email@example.com PaymentYou will be given the opportunity to pay the registration fee by credit card after completing the form. If you choose to pay via another option, please understand that your registration is considered incomplete until payment is received. While we strongly recommend using this online form to register for the conference (doing so helps accuracy and saves us considerable time), there is also a paper version of the form available: Registration Form. (Note: To submit the paper version electronically, you must download it and use the Adobe Reader software (free at get.adobe.com/reader) to fill it out. If you fill it out and try to submit it from within a web browser, it will not work.) Refund Policy Cancellation requests received before April 5, 2022 will receive a 100% refund on registration and event fees, minus a processing fee of $75. Cancellation requests received after April 5, and before June 5, 2022 will receive a 50% refund on registration and event fees, minus a processing fee of $75. No cancellation/refund requests will be accepted after June 5, 2022. All refund requests must be received in writing and will take approximately 2 weeks from the date of receipt to process. Email/Mail your registration form with your cancellation request to the Registrar, Karen Harris, firstname.lastname@example.org, briefly stating your situation. In the case of emergency/extenuating circumstance requests will be considered following the conference by the Conference Committee. Housing is separate from your registration. All hotel cancellations are subject to the housing/hotel cancellation policy, available in your housing confirmation email. Photography Release Waiver In the course of this conference and its associated events, a photographer will be documenting the activities, meetings, services, etc. that take place. These photos may subsequently be used by the Association and/or the Conference Committee for publication via the web, in promotional materials and in the Association’s social media pages. By registering and attending this conference, you are indicating consent for use, as discussed above, of any images that contain your likeness in whole or in part. If you do not wish to have your photograph used as described above, you may so state in writing in a communication addressed to email@example.com. Personal InformationProof of Vaccination against the COVID-19 virus(Required) I have been fully vaccinated and will submit a copy of my vaccination record now. I have been fully vaccinated but will submit a copy of my vaccination record at a later time. (See our Vaccine Verification upload page.) I have been fully vaccinated but will show my completed vaccination card at the conference registration check-in I am unable to receive the vaccination. I understand that I must provide proof of a negative COVID-19 test within 72 hours of the beginning of the conference. Upload your Vaccination RecordAccepted file types: jpg, jpeg, gif, png, pdf, tif, tiff, Max. file size: 5 MB.First Name (as on badge)(Required) Last Name(Required) Church/Company/Organization Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail(Required) Please check ALL that apply: This will be my first AAM Conference I am a new AAM member since the time of the July 2019 Boston Conference I have difficulty walking more than ¼ mile. (Transportation will be provided between venues.) I am a Vegetarian. I am a Vegan. I have other dietary restrictions. I DO NOT want my name included on the list of conference attendees. Please list any dietary restrictions: Note: Each year at our conference, a special reception is held to to welcome new members. Be sure to check the conference schedule for that and do plan to attend!Meals Below, please let us know if there are any Conference meals you will NOT be attending so that we may have an accurate head count. Note: Opting out of an included meal will not reduce your registration fee.I will NOT attend the following meals (choose ALL that apply): Monday Lunch (hotel) Tuesday Box Lunch Tuesday Dinner (Upper Shirley Vineyards) Wednesday Box Lunch Wednesday Dinner (All Saints') Thursday Closing Banquet (VFMA) Registration OptionsSCHOLARSHIPSAAM is eager to make conferences financially possible. Please email Ellen Johnston, Conference Co-Chair, (firstname.lastname@example.org) to enquire about scholarships. Note: Scholarships do not cover Pre-Conference or Post-Conference activities.Scholarships I am applying for a scholarship. Please do not send your registration fee until scholarship decisions are made. The deadline for Scholarship Application is March 1, 2022.Conference Registration(Required) AAM Member Registration (including spouses, partners, exhibitors, & ALCM members) — $495 ($575 after 3/1/2022) Non-Member Registration — $575 ($675 after 3/1/2022) I can only attend one of the pre- and/or post-conference events. Product NamePre-Conference Events(Required)Sunday, June 19th, buses depart hotel @ 4:30 St. Stephen's Celtic Evensong & Eucharist. Dinner on your own, Compline. (St. Stephen's offers a simple supper at nominal cost.) St. James's: Celebratory Concert with Dr. Carl Haywood. Dinner on your own. none Post-Conference Events(Required) Jefferson & Monticello — $120 Busch Gardens — $75 None TOTALTotal $0.00 Payment(Required) I will pay now by credit card (when you Submit this form, you will be redirected to Stripe.com for payment) I will write a check and mail it My church/company/institution will write a check and mail it I am applying for a scholarship Make checks payable to AAM 2022 Richmond and mail payment to: Karen Harris, Registrar 907 Yucca Lane North Chesterfield, VA 23236 email@example.comImportant: Please include AAM member name in Check Memo so that we know to whose account it should be credited.Make checks payable to AAM 2022 Richmond and mail payment to: Karen Harris, Registrar 907 Yucca Lane North Chesterfield, VA 23236 firstname.lastname@example.orgPhoneThis field is for validation purposes and should be left unchanged.