Please register me for: CURRENT
CONCEPTS IN WOUND HEALING™ for: (Fill in City/State
& dates) ______________________________________.
Please register me for: ADVANCED WOUND HEALING™
for: (Fill in City/State & dates) ______________________________________.
CIRCLE ONLY ONE PAYMENT TYPE
(Payment by www.paypal.com
is preferred) Using your credit card at
Pay Pal is easy!
1.) I paid by www.paypal.com Pay
2.) A check is enclosed: Make it payable for either $399 Early Bird
Special (30 days prior to program) or $449 (FOR EACH SEMINAR) to and
Wound Care Resources, Inc.
180 Cherry Street
Williams Bay, WI 53191-9704
I understand and agree that the seminar cost is not refundable for any
reason except that a full refund of course cost will occur if Wound
Care Resources, Inc.(WCR) cancels a seminar for any reason under its
control. Liability for refund is limited to course cost and not for
any other expense that may be incurred by the registrant. WCR will not
be held liable for any refund should a course be interrupted by an act
of God or an act of war or for circumstances beyond its control. The
materials presented in CURRENT CONCEPTS IN WOUND HEALING™
and ADVANCED WOUND HEALING™ by WCR and
Jeffrey A. Feedar, PT, CWS®, (Speaker) are presented for information
purposes only and WCR and the Speaker accepts no responsibility or liability
for a course participant to implement this information in any specific
patient plan of care or any other setting. Each course participant agrees
they are wholly responsible to determine the appropriateness of materials
presented, for practicing under the laws in the state and/or country
in which they practice, and for practicing within the scope of their
license. Each course participant will be required to sign a release
statement on day one of the seminar prior to the seminar beginning.
No registrations will be accepted without this form filled out (*
= required field) by the registrant and registrant's signature
and agreement to these conditions.
Your signature on this registration form states that you have
read, understood, and agree to these conditions governing WCR seminars
and information presented by the Speaker.
*Name (print) ____________________________________________________________________
*Credentials (PT, PTA, RN, LPN, MD, OT, CWS®, DO, DPM, NHA, ATC,
* License number(s) and State(s) (For CEU CERT.)______________________________________
*Home Address (DO NOT use your work address as we register people not
*Phone (home) (_______________)___________________________________________________
*(Very helpful!) Email______________________________________________________________
PLEASE CHECK YOUR EMAIL FOR CONFIRMATION LETTER - This is where we
will send your confirmation letter if you supply your email address!
*Signature_____________________________________________ *Date _____________________