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Registration Form - Annual Conference

Annual Conference Registration: (Registration Details)

Please fill out the form below to submit your registration for the 2012 KSAPT Annual Conference "Childhood, Interrupted: "Abuse-Informed Play Therapy for Sexually Abused Children & Adolescents"

If you have any questions prior to registering, please contact our Conference Coordinator.

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RPT YesNo

RPT-S YesNo
LCSCW/LCSW YesNo
MSW/LMSW YesNo
MFT/LMFT YesNo
LPC YesNo
FT Grad Student Yes No If Student: University/Program 
 
Educator / Counselor YesNo If Educator: List School
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APT Approved Provider #02-118

Approved Provider status is granted by the Association for Play Therapy; this allows registrants to earn credit at KSAPT programs towards their Registered Play Therapist or Registered Play Therapist-Supervisor credentials.

 

Refund Policy: ANNUAL CONFERENCE (May 3 & 4, 2012) 1. If a participant withdraws from the conference prior to APRIL 15th, 2012; the participant will receive a full refund, minus a $20 processing fee. An email must be sent to and received by our Conference Chair at: conference@ksa4pt.org, in order to receive the refund. The withdraw email request must be received prior to the stated deadline above. 2. If a participant withdraws AFTER APRIL 15th, the registrant will receive a partial refund (half of fee paid), minus a $20 processing fee. 3. Individual Hotel Room rate refunds reside with the Venue or Hotel Policy, and is an individual responsibility. KSA4PT is not responsible for mediating refunds with any venue for our events. ** If a paid participant needs to withdraw from the annual conference or speaker series; they can select to "donate" their paid registration to students on the KSA4PT scholarship list or another professional individual.

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Kansas Association for Play Therapy KSAPT, P.O. Box 1357, Cimarron, KS   67835