There are two options available for registration.

• Download and print a copy of the 2012 Kentucky EMS Conference and Expo Brochure (available Summer 2012 in PDF format) and complete and mail-in the included registration form. You cannot use a credit card when you mail in your registration.

• Easiest registration method: Register On-Line (available Summer 2012) through our encrypted secure site with your major credit card, e-check, or PayPal.

Confirm your registration.

• After a registration is received (if received by September 14) and processed, a confirmation is sent by e-mail or U.S. Postal mail to the address included with the registration form.

• EMS Golf Scramble, September 18, 2012: $__

• 1-Day Wednesday Conference Registration, September 19, 2012: $__

• 1-Day Thursday Conference Registration, September 20, 2012: $__ (does not include a recognition banquet ticket or admittance to the Medical Directors Workshop).

• 1-Day Friday Conference Registration, September 21, 2012: $__

• SPECIAL 3-Day Early Registration, September 19 - 21 (does not include the banquet or admittance to the Medical Directors Workshop): $120 if purchased by August 31

• Special Track: 1-Day Medical Directors Workshop, Thursday, September 20, 2012: $100 for both the Medical Director and the EMS Service Director (does not include a recognition banquet ticket or admittance to the main conference sessions.) Registration admits 2 provided they both meet the requirement of one being the service physician medical director and the other being the service EMS director. Additional participants can register for $50 each.

Kentucky EMS Recognition Banquet:

• Tickets to the Kentucky EMS Recognition Banquet on September 20, 2012 are $35 each while supplies last. Ticket sales will end on Sept. 18 (subject to availability).

Registrations with payment should be mailed to:

Kentucky EMS Conference
PO Box 1736
Inez KY 41224

PAYMENT MUST ACCOMPANY ALL REGISTRATIONS

Mailed-In Registrations: A check (payable to KAPA) or money order must accompany your mailed-in registration. Please do not send cash. Phone, fax, and e-mail registrations cannot be accepted.   Absolutely no registration will be processed (or banquet tickets held) without payment. Registrations that do not include the complete payment will be returned unprocessed.
     Purchase Orders are not accepted. You can determine the registration cost by completing our registration form and sending your completed registration form to your finance department (please instruct them to attach the form to the payment). Payment must be received at the time of any purchase.

On-Line Registration: You may use your Mastercard, VISA, American Express, Discover, e-check, or PayPal for payment when registering on-line. Payment must be made at time of on-line registration.

Please include your daytime phone number on your registration form. If a phone number is not provided, registrations that cannot be processed will be returned unprocessed.

Processing of registration forms received on or after September 14 will be delayed. You are encouraged to mail your registration allowing ample time for delivery prior to September 14. Registration can be done on-site at the conference (awards banquet tickets subject to availability).