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New User Registration

Event Information
Event Title: **CANCELED** Bal-A-Vis-X (Oregon)
Sub Title: Rider #403
Agency: CESA 4
Location: Oregon High School
456 North Perry Parkway
Oregon, WI 53575
Facility: Gymnasium/Cafeteria
Date/Time:
4/18/2020 08:30 AM - 05:00 PM Registration will begin at 8:15am; meals are not provided.
4/19/2020 08:15 AM - 04:30 PM Registration will begin at 8:00am; meals are not provided.
Your Name
* First Name:
* Last Name:
Preferred Badge First Name:
Work Information
* Organization Type:
WI Public School District
School District not in WI
OR
Agency/Organization
WI Private School
Individual/Parent/Other
* Email: * This will be your login ID
* Confirm Email:
* Password: (must be at least 6 characters long)
* Confirm Password:
* Position / Title:
* Phone Number:
Ext.
Fax Number:
* Do you Require Special Accommodations?
Yes
No
Home Information (Used for summer / holiday mailings)
* Home Address:
* Home City:
* Home State/Country:
For United States and Canada:
For Other Countries:
State:
Country:
* Home Zip:
Home Phone:
Cell Phone:
Home Email:
Categories You Belong To

Please select which categories are important so that we can better meet your needs - matching you to trainings and workshops that pertain to your position/role and ultimately to provide the tools and training to perform your job(s).