2022 Convention Registration Form

Fair/Festival/Event or Associate Registration

Fair/Festival/Event or Associate Registration Fair/Festival/Event Registration Associate Registration
Name of Fair/Festival/Event or Business Name *
Contact Person's Name *
Contact Person's Phone Contact Person's Phone * - ### - ### ####
Contact Person's Email *
Contact Person's Address Contact Person's Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Attendee #1 First & Last Name:
This name will be used on the name badge
Attendee #1 Email
Attendee #1 Address Attendee #1 Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Attendee #2 First & Last Name:
This name will be used on the name badge
Attendee #2 Email
Attendee #2 Address Attendee #2 Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Attendee #3 First & Last Name:
This name will be used on the name badge
Attendee #3 Email
Attendee #3 Address Attendee #3 Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Attendee #4 First & Last Name:
This name will be used on the name badge
Attendee #4 Email
Attendee #4 Address Attendee #4 Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Attendee #5 First & Last Name:
This name will be used on the name badge
Attendee #5 Email
Attendee #5 Address Attendee #5 Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
For More Registrations for your Organization, please fill out an additional registration form.

Do not duplicate attendees between multiple forms.
Registration Fee Per Participant Paid Prior to November 5, 2021 is $155.00*
After November 5th the fee is $175.00*

Registration Fee (Paid Via Check) by November 5, 2021;$155.00

Registration Fee (Paid Via Credit Card) by November 5, 2022: $159.65 (Includes 3% Convenience Fee)

Registration Fee (Paid Via Check) after November 5, 2022: $175.00

Registration Fee (Paid Via Credit Card) after November 5, 2022: $180.25 (Includes 3% Convenience Fee)
Check Payments are accepted.

Print this form and mail payment to:
Heartland Association of Fairs, Festivals & Events
PO Box 181
West Fargo, ND 58078
Complete the below If paying by Credit Card: Please note by providing your credit card information you are acknowledging you will be billed a 3% credit card transaction fee (listed above). Credit cards will be processed on/after October 1st.

Complete the below If paying by Credit Card: Please note by providing your credit card information you are acknowledging you will be billed a 3% credit card transaction fee (listed above). Credit cards will be processed on/after October 1st. Visa Mastercard Discover
Name on Card
Credit Card Number
Expiration Date
3 digit code
Billing Address Billing Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
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Full Name

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2022 Convention Registration Form

For More Registrations for your Organization, please fill out an additional registration form.

Check Payments are accepted.