Clone of Community Registration - EF Symposium 2026 Registration Form

Seeds of Learning® 2026 Executive Function Symposium

Please complete the form below to register for the Seeds of Learning® 2026 Executive Function Symposium and secure your spot!
SYMPOSIUM DATES: July 27-29, 2026. LOCATION: The Emerald Event Center - 33040 Just Imagine Dr. Avon, OH 44011
Full Name*

First NameLast Name
E-mail*
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Verify E-mail*
example@example.com
Cell Number*
May we text symposium reminders to the phone number above?*

YesNo
Address*

Street Address

Street Address Line 2

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Postal / Zip CodeCountry
Your profession: *
If you selected Other above, please write your profession below:
In what setting(s) do you work? Check all that apply.*

SchoolPrivate PracticeEarly InterventionHospital InpatientHospital OutpatientHigher Education
With what population(s) do you work? Check all that apply.*

Birth to fiveElementary school ageMiddle school ageHigh school ageYoung adult (18-25)Adult (25+)
Emergency Contact 1*

First NameLast Name
Emergency Contact 1 Phone Number*
Please enter a valid phone number.
Emergency Contact 2*

First NameLast Name
Emergency Contact 2 Phone Number*
Please enter a valid phone number.
Please list any accessibility needs you may have:
List any allergies you have that we should know about:
Boxed lunches will be provided on Monday (Day 1) and Tuesday (Day 2) at no additional cost to attendees. Please select your choices below.

Along with your choices below, each boxed lunch will contain: whole fresh fruit, potato chips, fresh baked cookies, candy bar, condiments, bottled water, and a soft drink. Additional lunch options are available within walking distance of the venue (at attendees’ expense) including Chipotle, Starbucks, Hummus Republic, and Honeygrow. Please note that the event center is unable to accommodate kosher meals. If you keep a strictly kosher diet, we kindly ask that you bring your own lunch.
Monday boxed lunch choice:*
Tuesday boxed lunch choice:*
Please list any dietary restrictions:
Would you like to join the Sip & Social event at 4:00 p.m. on Monday? This event is provided by Seeds of Learning and is no additional cost to attendees.*

YesNo
Tuesday Breakout Sessions

You will be able to attend TWO breakout sessions. Please note that breakout sessions may fill to capacity. We will do our best to accommodate your top two requests, and if any changes are necessary, we will contact you by email.
Tuesday Breakout Session First Choice*
Tuesday Breakout Session Second Choice*
Tuesday Breakout Session Third Choice (if one of your top two choices is full)*
How did you hear about the Seeds of Learning® 2026 Executive Function Symposium?*
ACKNOWLEDGMENT OF CERTIFICATE OF COMPLETION: By checking this box, I acknowledge and agree that: (1) I will receive a certificate of completion to the email address provided above verifying my participation in the Seeds of Learning® 2026 Executive Function Symposium; (2) this certificate of completion is provided for documentation purposes only and is not equivalent to formal continuing education units (CEUs) approved by any licensing or accrediting organization; and (3) Seeds of Learning, LLC makes no claim or representation that these certificates fulfill professional CEU requirements for any state, national, or international licensing body.*

I acknowledge and accept the above terms.
CANCELLATION POLICY: Cancellations received in writing on or before April 30, 2026, will be eligible for a full refund, minus a $75 processing fee. No refunds after April 30, 2026; cancellations received after this date, as well as no-shows, are not eligible for a refund. All refund requests must be submitted in writing to accounting@seedsoflearningllc.com. Registrations may be transferred to another participant at no additional cost. Requests for transfer must be submitted in writing prior to the start of the event. In the event of Seeds of Learning® 2026 Executive Function Symposium cancellation, postponement, or schedule changes, the organizer’s sole responsibility is limited to the refund of the paid Symposium registration fee in accordance with this policy. The organizer is not responsible for, and will not reimburse, any additional costs incurred by participants, including but not limited to travel expenses, airfare, hotel accommodations, transportation, meals, or other incidental costs. By completing registration, participants acknowledge and accept these terms.*

I acknowledge and accept the above terms.
By attending the Seeds of Learning® 2026 Executive Function Symposium, you agree to the following: You are responsible for yourself. Seeds of Learning, LLC will provide a safe and welcoming event, but you are responsible for your own health, safety, and belongings. Seeds of Learning, LLC is not responsible for injury, illness, lost property, or other issues that may arise, except in rare cases of gross negligence. The Seeds of Learning® 2026 Executive Function Symposium will be photographed and recorded. By attending, you agree that your image or voice may be used in our educational or promotional materials. In case of an emergency, you authorize Seeds of Learning, LLC to seek medical help on your behalf if needed, and you agree to cover any costs of that care. Seeds of Learning, LLC reserves the right to make changes to the program or substitute speakers, as needed.*

I acknowledge and accept the above terms.
How are you paying?*

As an individual with a credit cardWith a purchase order (P.O.) Must be attached below. Payment for P.O. must be received no later than May 31, 2026 to avoid cancellation of registration.
Upload Purchase Order PDF Here*

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My Products*

Seeds of Learning® Symposium-Early Bird Pricing (Feb. 1-April 1)Regular Pricing (April 2 – June 28): $695 - Late Pricing (June 29 - July 12): $745

$635.00

Total

$0.00

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Seeds of Learning® 2026 Executive Function Symposium

SYMPOSIUM DATES: July 27-29, 2026. LOCATION: The Emerald Event Center - 33040 Just Imagine Dr. Avon, OH 44011

Boxed lunches will be provided on Monday (Day 1) and Tuesday (Day 2) at no additional cost to attendees. Please select your choices below.

Tuesday Breakout Sessions