Home/Event Info/Participant Registration

45th Annual · April 13-15, 2027

Participant Registration

Reserve your seat for three days of MSHA updates, certified trainings, expert sessions, and networking at the Choctaw Conference Center.

Early Rate

$375

Per person, through March 1, 2027

After March 1

$425

Late registration per person

Included

All meals

Refreshments, sessions & workshops

Good to know: register up to 8 people on one form. Name badges are printed from the names and job titles you enter. No refunds for no-shows or cancellations after March 25, 2027.

"*" indicates required fields

Comments

This field is for validation purposes and should be left unchanged.

Company Name:*

Company Address*

Street Address Address Line 2 City State ZIP Code

Person completing this form:*

First Last

Phone*

Email*

Participants Attending

IF REGISTERING MORE THAN 8 PERSONS, please fill out additional form. NOTE: We will print the name badges from the Names and Job Titles entered below.

How many Participants Attending?*

Participant #1*

First Last

Phone - Participant #1*

Job Title - Participant #1*

MSHA ID NUMBER per Location - Participant #1*

Participant #2

Participant #2*

First Last

Phone - Participant #2*

Job Title - Participant #2*

MSHA ID NUMBER per Location - Participant #2*

Participant #3

Participant #3*

First Last

Phone - Participant #3*

Job Title - Participant #3*

MSHA ID NUMBER per Location - Participant #3*

Participant #4

Participant #4*

First Last

Phone - Participant #4*

Job Title - Participant #4*

MSHA ID NUMBER per Location - Participant #4*

Participant #5

Participant #5*

First Last

Phone - Participant #5*

Job Title - Participant #5*

MSHA ID NUMBER per Location - Participant #5*

Participant #6

Participant #6*

First Last

Phone - Participant #6*

Job Title - Participant #6*

MSHA ID NUMBER per Location - Participant #6*

Participant #7

Participant #7*

First Last

Phone - Participant #7*

Job Title - Participant #7*

MSHA ID NUMBER per Location - Participant #7*

Participant #8

Participant #8*

First Last

Phone - Participant #8*

Job Title - Participant #8*

MSHA ID NUMBER per Location - Participant #8*

Card Billing Information

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Registration Rate (per participant)*

Select the rate that applies on your registration date. Quantity is set by the number of participants above.

Early Registration - through March 1, 2027

Late Registration - after March 1, 2027

Total Due

DEADLINE TO REGISTER IS MARCH 1, 2027

Cancellation/Refund Policy:

After March 1, 2027, late registration fees increase to $425.00 per registrant.
No refunds for no-shows or cancellations after March 25, 2027.
Name substitutions (swapping attendees) are allowed at no charge if requested prior to the conference start date. After April 10, 2027, a $25 processing fee will apply to each name change.

NOTE: Name badges will be printed using the names and job titles provided above.

By registering for the conference, you understand that photographs will be taken and used on our website.

ALL PERSONAL INFORMATION WILL BE PROTECTED
THANK YOU FOR YOUR SUPPORT!

Credit Card*

Participant Registration

Early Rate

After March 1

Included

Participants Attending

Participant #2

Participant #3

Participant #4

Participant #5

Participant #6

Participant #7

Participant #8

Card Billing Information

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