Youth Canvas Conference Registration

Important Dates to Know

Early bird ends Friday, April 4, 2025
Registration closes Friday, April 18, 2025
Conference held on May 1-2, 2025

If you have questions about registration, please contact Kia Kjensrud at kkjensrud@wiaap.org.

Support Opportunities

Youth Canvas offers a wide range of opportunities for exhibitors and sponsors to connect with our attendees in meaningful ways. Secure your spot today by registering below.

Conference Registration

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I am a(n) *

Conference Attendee
Exhibitor
Staff Member
Event Speaker
Event Volunteer

RSVP for Free Film Screening *

Yes, I would like to attend!
No, I am not able to attend.

Select Your Registration Level

Registration rates cover attendance for both days of the conference, providing participants with full access to all sessions, breakout sessions, film screening, networking opportunities, and other activities scheduled over the course of the two-day conference.

Registration Level - Early Bird Rate *

Trainee/Student - $25.00
Community Member - $49.00
Allied Health - $49.00
MD/DO - $129.00

Community Member: We welcome all community members to join this event, whether you are a parent, teacher, family member or loved one of someone struggling with mental illness or you’re just interested in learning more about this topic. You are welcome to join!

Allied Health: All health care workers are welcome to join this event including (but not limited to): advanced practice providers, nurses, paramedics/EMTs, therapists, dietitians, etc.

Exhibitor Information

Payment Type *

Pay by Credit Card
Pay by Check
I require an invoice for payment
Other Payment

(Please specify other payment)

Select Level of Support, and Add-ons. (Select all that apply.) *

$5,000 - Chapter Sponsorship (includes an exhibit table)
$1,500 - Exhibit Table
$7,500 - Conference Opening Host and Community film screening event of CAREgivers film
$6,500 - Stanley Mugs w/logo
$5,000 - Lunch
$3,500 - Umbrellas w/logo
$2,000 - Afternoon snack
$1,500 - Mini desk vacuums w/logo
$500 - Gift cards - drawing
$500 - Gift cards - app
$200 - Pens w/logo

Pay by Check

Make your selection below, print, include check payment, and mail to WIAAP, PO Box 243, Oconomowoc, WI 53066. Please include “WIAAP 2025 Conference” and any purchase order in memo line.

Upon registration you will receive confirmation of your order, and next instructions on next steps for registration for booth staff.

Select Level of Support, and Add-ons. (Select all that apply.) *

$5,000 - Chapter Sponsorship (includes Exhibit Tables)
$1,500 - Exhibit Table
$7,500 - Conference Opening Host and Community film screening event of CAREgivers film
$6,500 - Stanley Mugs w/logo
$5,000 - Lunch
$3,500 - Umbrellas w/logo
$2,000 - Afternoon snack
$1,500 - Mini desk vacuums w/logo
$500 - Gift cards - drawing
$500 - Gift cards - app
$200 - Pens w/logo
Other

Other (Please describe.)

Please enter your PO number and any special instructions (if applicable).

Company or Organization Information

Company or Organization Name *

Billing Contact Name *

Billing Contact Email *

Billing Contact Phone *

Billing Contact Address *

Address Line 1

Address Line 2

City

State

Zip Code

How many staff members will be attending?

1st Staff Member Information

Staff 1: Contact Name

Staff 1: Cell Phone

Staff 1: Contact Email

Staff 1: Credentials

Staff 1: AAP ID#, if applicable

Staff 1: Job Title

Staff 1: LinkedIn Profile URL

Staff 1: Pronouns

Staff 1: Emergency Contact Name

Staff 1: Emergency Contact Phone

Staff 1: Accommodations to enhance this staff member's conference experience

2nd Staff Member Information

Staff 2: Contact Name

Staff 2: Cell Phone

Staff 2: Contact Email

Staff 2: Credentials

Staff 2: AAP ID#, if applicable

Staff 2: Job Title

Staff 2: LinkedIn Profile URL

Staff 2: Pronouns

Staff 2: Emergency Contact Name

Staff 2: Emergency Contact Phone

Staff 2: Accommodations to enhance this staff member's conference experience

Attendee Information

Staff Member Information

Speaker Information

Volunteer Information

Name *

First

Last

Phone *

Email *

Credentials

AAP ID#, if applicable

Job Title *

Company / Organization *

Discipline

Please specify.

Accommodations & Emergency Contact Information

Do you require any additional accommodations to improve your conference experience? *

Lactation room
Food allergy
Other special dietary needs
Accessibility requirements
Other
None of the above

Please specify *

Emergency Contact Name *

Emergency Contact Number *

Additional Info About You

What is your LinkedIn profile URL?

Pronouns *

Please upload your headshot photo. *

Click or drag a file to this area to upload.

This photo will be used in the conference app and promotional materials.

Please provide your professional bio. *

This description will be used in the conference app and promotional materials.

By registering for this conference, you agree to the use of your photo for marketing purposes and to the sharing of your name and email address with vendors, exhibitors, and fellow attendees through the conference app.

By registering for this conference, you agree to the use of your photo, staff member photos, and exhibitor booth for marketing purposes and to the sharing of all names and email addresses with vendors, exhibitors, and fellow attendees through the conference app.

Payment Methods

Payments are processed through PayPal. You may use an existing PayPal account by selecting PayPal Checkout from the drop-down menu below.

To use your existing credit card, select Credit Card.

PayPal Commerce *

Card Number

Expiration Date

Security Code

Card Holder Name

Billing Address