Empowered Life Summit Exhibitor Registration - March 27, 2024
Thank you for your interest in the Empowered Life Summit! 
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Email *
Business/Organization Name (written exactly as it should be listed in materials and on name badge) *
Contact Person *
Is there anyone else who needs to get event exhibitor emails? If so include their email addresses here, separated by commas if more than one. 
Phone *
Mailing Address (include city, state, and zip) *
Names of all exhibitor representatives as they should be listed on name badges. *
If your exhibitor representatives would like an event t-shirt, please list t-shirt sizes. 
Website 
Facebook Page (if applicable)
A brief summary of the information, resources, activities, etc.,  you will provide at your booth. *
Do you need more space beyond a 6ft table and standing room? If so, let us know how much space you need and what they space will be used for. 
Do you need electrical access? It is very limited and must be pre-arranged. If you need electrical access, what do you need it for? 
Payment due:  *
Payment will be made by: *
Any special requests, needs, or questions?
Thank you for registering for the Empowered Life Summit!
Contact Jennifer Clark with any questions you may have: Jennifer@EmergeEvents.com or 601-270-2756. We will be in touch with more information.
A copy of your responses will be emailed to the address you provided.
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