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Page 1: come - Wichita State University · 2020-05-05 · ACCESSING THE VIRTUAL CONFERENCE PLATFORM. Conference attendees will gain access to the virtual platform beginning June 1, 2020
Page 2: come - Wichita State University · 2020-05-05 · ACCESSING THE VIRTUAL CONFERENCE PLATFORM. Conference attendees will gain access to the virtual platform beginning June 1, 2020

131ST ANNUAL STATEWIDE SUMMER CONFERENCE FOR KANSAS SCHOOL NURSES

Welcome

Adapt and Thrive in a Rapidly Changing EnvironmentThe Kansas School Nurse Organization is thrilled to bring you its first-ever virtual conference. Nursing education is more important than ever, as is maintaining public health. That's why we're working around the clock to bring you the summer conference you know and love in a safe and efficient environment: your own home.

Events formatted for optimal learning and connection.• Three motivating keynotes• 25+ expert-led breakout sessions• One-on-one networking opportunities with fellow attendees• Exhibitor and sponsor expo• Live, moderated sessions with the opportunity for networking and Q&A• Access to recorded sessions for 30 days• 15 CNE hours for General Session and 8.4 CNE hours for New Nurse Orientation• Premium Pass option to earn 5.4 additional CNE's and access recordings for 90 days

Attend from Anywhere

While other events are closing, we're

launching a full four-day live event that

allows you to participate from anywhere

using a mobile device or laptop.

Access Sessions & Materials for 30 Days

You don't have to decide between

sessions. Attend the ones you want.

With free 30-day recorded access, or by

purchasing the Premium Pass for 90-day

access, catch every dynamic session and

keynote to build powerful school nursing

practices.

25+ Interactive Breakout Sessions

Attend up to five live virtual expert-led

sessions. Then, you can watch the rest of

the sessions at your convenience.

Enjoy Three Motivational Keynotes

Get energized with thought-provoking

and exciting ideas. Our speakers will

leave you with a burning sense of

purpose, knowing you are capable of

accomplishing anything.

Save Money. Stay Safe.

With no travel, hotel, or meal costs, the

savings allow us to provide high-quality

professional training to even more school

nurses.

High-Impact Instruction

What better way to end a difficult school

year and inspire your administration

than on an upbeat note? As nurses and

educators united and determined, our

mission of a better future has no limits.

Page 3: come - Wichita State University · 2020-05-05 · ACCESSING THE VIRTUAL CONFERENCE PLATFORM. Conference attendees will gain access to the virtual platform beginning June 1, 2020

ACCESSING THE VIRTUAL CONFERENCE PLATFORMConference attendees will gain access to the virtual platform beginning June 13, 2020. Attendees

will receive an email with log-in instructions. Once you've logged in and created your profile, you

can choose your sessions, access materials, view exhibitor profiles, schedule one-on-one meetings

with other attendees, and more.

Technical support will be available leading up to and throughout the conference.

2 31ST ANNUAL STATEWIDE SUMMER CONFERENCE FOR KANSAS SCHOOL NURSES

THANK YOU TO OUR MAJOR SPONSORS

CONFERENCE PLANNING COMMITTEEMary Ann Bauman, RN, USD #461 Neodesha

Katrina Benyshek, BSN, RN, NCSN, Conference Chair, USD #214 Ulysses

Darlene Coffey, MSED, BSN, USD #457 Garden City

Windy Garrett, MSN, USD #500 Kansas City, Kansas Public Schools

Sue Holmes, BSN, RN, NCSN-E, Salina

Kimber Kasitz, BSN, RN, NCSN, KSNO President, Director of Health, Homebound & 504 Services, USD #259 Wichita

Abby Martin, BSBA, RN, USD #343 Perry-Lecompton

Jolene Morrison, LPN, USD #345 Seaman

Elisa Nehrbass, MEd, Kansas Department of Health and Environment

Debra Pile, DNP, APRN, P-CNS, Associate Professor and Coordinator of the Accelerated BSN Program, Wichita State

University School of Nursing

Valerie Rainman, RN, BA, CSN, Garden City

Mary Ann Shorman, BSN, RN, Hays

Holly Steinlage, MPH, RD, LD, Child Nutrition Program Consultant, Kansas State Department of Education

Annie Wallace, MSN, RN, Assistant Professor of Nursing, University of Central Missouri

Page 4: come - Wichita State University · 2020-05-05 · ACCESSING THE VIRTUAL CONFERENCE PLATFORM. Conference attendees will gain access to the virtual platform beginning June 1, 2020

GENERAL CONFERENCE

GENERAL SESSIONEVERY DAY COUNTS: BEHIND EVERY SUCCESSFUL STUDENT IS A SCHOOL NURSE

School health professionals are in unique positions to affect change in their school population, community and within themselves using knowledge and expertise in assessment and health planning to build relationships, collaborate with students, families, and other disciplines to lead change in the health and education of the future of our students.

This year’s theme, “Every Day Counts: Behind Every Successful Student is a School Nurse,” reminds us that a student has the best chance of succeeding in the educational environment when they are in that educational environment every day. School nurses assist students in that endeavor by providing health services in the school setting. School nurses provide students and families with the opportunities to facilitate the important connection between school, community and the student. Presenters will engage participants in recognizing the opportunities and strategies to provide a continuum of care for school health professionals to begin collaborating for the 2020-2021 school year.

OBJECTIVESRecognize and identify events that occur in the daily life of students than can affect

attendance and performance in their daily lives.

Identify potential threats to health and safety in the school setting and the strategies to employ, prepare, mitigate and respond to preserve the physical and emotional well-being of schools and the community.

Recognize how attitude and approach to challenges positively or negatively affect school students and staff in their daily lives.

Identify the role of the school health professionals in the surveillance, prevention, and management of chronic, acute, and infectious diseases.

Review common health conditions in pediatric and adolescent populations and strategies for responding and managing chronic and urgent health needs with health care and education partners.

Compare current personal and professional school heath professional practices with evidence-based practices to design a plan to incorporate interdisciplinary partners in improving health and education outcomes for school populations and communities.

331ST ANNUAL STATEWIDE SUMMER CONFERENCE FOR KANSAS SCHOOL NURSES

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NEW NURSE ORIENTATION

ABOUT THE SESSIONThe New School Nurse Orientation provides a comprehensive overview of policies and procedures in school health. The sessions bring together a faculty of seasoned school nurses and other state experts who share knowledge, expertise and evidence-based practice in the following areas: communicable disease; immunizations; special health care needs; procedures and interventions; medication administration; and emergency planning and response.

Speakers discuss the importance of school health as an essential component of the academic curriculum and its importance in student achievement. As a participant, you will learn about your role and legal responsibilities within the framework of the Kansas Nurse Practice Act as well as the Scope and Standards of School Nurse Practice. All nurses (RN and LPN) who provide services in any school setting are invited to attend this session.

OBJECTIVESBy the conference conclusion, participants should be able to:

Integrate evidence-based nursing practice in an interdisciplinary Kansas education structure.

Locate laws and standards impacting school health programs and the school nurse.

Discuss the development and implementation of policies and procedures.

Describe the role of the school nurse in identifying, reporting, and preventing communicable diseases in the school setting.

Examine the current immunization schedule with application to school health.

Define delegation and implications to nursing practice in the school setting.

Identify day to day school nursing planning and management strategies.

Differentiate the purpose and requirements for the various plans of care for students that include health care plans, Section 504 Plans, and Special Education Plans.

Discuss the role of the school nurse in emergency planning and response in the school setting.

Describe the value of effective communication and collaboration to enhance student and family capacity for adaptation, self-management, self-advocacy, and learning.

4 31ST ANNUAL STATEWIDE SUMMER CONFERENCE FOR KANSAS SCHOOL NURSES

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531ST ANNUAL STATEWIDE SUMMER CONFERENCE FOR KANSAS SCHOOL NURSES

MONDAYJuly 20

8 - 9 KSNO & NASN WELCOMETHE TOP TEN THINGS YOU NEED TO KNOW AS A SCHOOL NURSE

NEW NURSE ORIENTATION

Kimber Kasitz, BSN, RN, NCSN, KSNO President, Director of Health, Homebound & 504 Services, USD #259 Wichita

Sharon Morris, MSN, RN, KSNO NASN Representative, Director of Health Services, Olathe Public Schools Mill Creek Campus

Katrina Benyshek, BSN, RN, NCSN, Conference Chair, USD #214 Ulysses

9:15 - 10:45 SCHOOL NURSING LAWS AND STATUTESSharon Morris, MSN, RN, KSNO NASN Representative, Director of Health Services, Olathe Public Schools Mill Creek Campus

11 - 12 MEDICATION AND DELEGATIONKimber Kasitz, BSN, RN, NCSN, KSNO President, Director of Health, Homebound & 504 Services, USD #259 Wichita

12 - 1 BREAK FOR LUNCH

1 - 2 DISEASE REPORTING AND VACCINE-PREVENTABLE DISEASE (VPD) CASE AND OUT-BREAK INVESTIGATIONS: THE ROLE OF A SCHOOL NURSE Allison Zaldivar, MPH, Epidemiologist, Infectious Disease Epidemiology and Response, Kansas Department of Health & Environment

2:15 - 3:15 IMMUNIZATIONS: THE ROLE OF THE SCHOOL NURSEBecky Prall, RN, IQIP Coordinator/Immunization Nurse Educator, Kansas Immunization Program, Kansas Department for Health & Environment

3:30 - 4:30 EMERGENCY PREPAREDNESS & SCHOOL NURSE MANAGEMENTChris Tuck, MS, BSN, RN, NCSN, USD #345 Seaman

4:30 - 5 ORIENTATION Q&ANew Nurse Orientation Presenter Panel

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TUESDAYJuly 21

6 31ST ANNUAL STATEWIDE SUMMER CONFERENCE FOR KANSAS SCHOOL NURSES

WELCOME & CONFERENCE OVERVIEW

More Than Meets the EyeRuss Tuttle, BA, Founder & President, The Stop Trafficking Project, Inc.

GENERAL SESSION, DAY 18:45 - 9

9 - 9:30 LEGISLATIVE UPDATECrystal Krueger, NP, MS, KSNO Legislative Chair, Blackbob Elementary School, Olathe

Sharon Morris, MSN, RN, KSNO NASN Representative, Director of Health Services, Olathe Public Schools Mill Creek Campus

9:45 - 11:15 OPENING KEYNOTE

11:15 - 12 BREAK FOR LUNCH

12 - 1:30 BREAKOUT SESSION BLOCK 1

1:45 - 3:15 BREAKOUT SESSION BLOCK 2

3:15 - 3:30 DAY 1 CLOSING SESSION

WEDNESDAYJuly 22

WELCOME

GENERAL SESSION, DAY 29 - 9:10

12:30 - 1:30 BREAK FOR LUNCH

1:30 - 2 KSNO BUSINESS MEETING

2 - 3:30 BREAKOUT SESSION BLOCK 5

3:30 - 3:45 DAY 2 CLOSING SESSION

9:15 - 10:45 BREAKOUT SESSION BLOCK 3

11 - 12:30 BREAKOUT SESSION BLOCK 4

Kimber Kasitz, BSN, RN, NCSN, KSNO President, Director of Health, Homebound & 504 Services, USD #259 Wichita

Katrina Benyshek, BSN, RN, NCSN, Conference Chair, USD #214 Ulysses

Kimber Kasitz, BSN, RN, NCSN, KSNO President, Director of Health, Homebound & 504 Services, USD #259 Wichita

Katrina Benyshek, BSN, RN, NCSN, Conference Chair, USD #214 Ulysses

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thursdayJuly 23

WELCOME

GENERAL SESSION, DAY 39 - 9:15

12:30 - 12:45 DAY 3 CLOSING SESSION

9:15 - 10:45 KEYNOTE PRESENTATION

11 - 12:30 KEYNOTE PRESENTATION

COVID and the School Setting Panel

Panelists to be announced.

Emotional Health ACE’s

James Moffett, MEd, Educational Consultant

continuing education

CONTINUING NURSING EDUCATIONNew Nurse Orientation and General SessionWichita State University College of Health Professions is approved as a provider of continuingnursing education by the Kansas State Board of Nursing. This course offering is pending approvalfor contact hours applicable for RN, LPN or LMHT relicensure. Kansas State Board of Nursingprovider number: #LT 0090-0327. These course offerings are pending approval for 8.4 contact hours for the New School Nurse Orientation, 15.0 contact hours for the General Session, and 5.4 hours for Premium Pass sessions. Certificates will be emailed within 90 days following the conference and upon completion of session evalutions.

Important Information Regarding Contact Hours for Professional RelicensureAttendance will be recorded through the virtual platform system and verified in the session evaluations. To receive credit for an individual session, you must complete that session's evaluation.

In order to earn the entire 15 hours for the General Session, you must view all three keynotes, the half-hour legislative update, and five breakout sessions of your choosing. To be counted, these sessions must be viewed and evaluated no later than August 23, 2020.

In order to earn the entire 8.4 hours for New Nurse Orientation, you must view and evaluate all six New Nurse Orientation sessions plus the half-hour Orientation Q&A no later than August 20, 2020.

The Premium Pass allows you to view and evaluate three additional breakout sessions from the General Session for 5.4 hours of credit. These must be viewed and evaluated no later than October 23, 2020.

731ST ANNUAL STATEWIDE SUMMER CONFERENCE FOR KANSAS SCHOOL NURSES

Kimber Kasitz, BSN, RN, NCSN, KSNO President, Director of Health, Homebound & 504 Services, USD #259 Wichita

Katrina Benyshek, BSN, RN, NCSN, Conference Chair, USD #214 Ulysses

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Keynote Speakers

8 31ST ANNUAL STATEWIDE SUMMER CONFERENCE FOR KANSAS SCHOOL NURSES

RUSS TUTTLE, BA, FOUNDER & PRESIDENT, THE STOP TRAFFICKING PROJECT, INC.

Tuesday, July 219:45 - 11:15 am

Technology is not the enemy. But the reality is that our kids vulnerabilities can and are being exploited online. The worst-case scenarios have led to the crime of domestic minor sex trafficking. School nurses are uniquely positioned to keep students safer. This keynote is designed to impact your personal and professional life. An appropriate image and three words have the power to change your perspective. Together we will become increasingly educated and empowered for the sake of students we care about.

MORE THAN MEETS THE EYE

JAMES MOFFETT, MEd, EDUCATIONAL CONSULTANT

EMOTIONAL HEALTH ACE'SThursday, July 2311:00 - 12:30 pm

James Moffett was the principal of Derby Hills Elementary School in Derby, Kansas. Throughout his career, Moffett has taught various demographic groups, observing the differences and similarities in effective instructional and behavioral strategies. Ultimately, James realized what we all know: meaningful relationships enhance behavior and academic success. Moffett often threw around the words “grit” and “perseverance”, but after viewing Paper Tigers, it came full circle. Since then, James worked to create a trauma-informed environment at Derby Hills Elementary, encompassing safe spots, mindfulness, self-regulation and an explicit SEL curriculum. James recently resigned his position as principal to take on full time consulting work. He launched JM Educational Consulting in April of 2019 and is looking forward to sharing the trauma-informed message around the globe.

Thursday, July 239:15 - 10:45 am

This moderated panel discussion will examine the impact of the Coronavirus in schools and school children, and what actions school nurses should take to keep schools healthy. Panelists to be announced.

COVID AND THE SCHOOL SETTING

Page 10: come - Wichita State University · 2020-05-05 · ACCESSING THE VIRTUAL CONFERENCE PLATFORM. Conference attendees will gain access to the virtual platform beginning June 1, 2020

THE BREAKOUT SESSION SCHEDULE WILL BE AVAILABLE IN THE VIRTUAL PLATFORM. SOME LIVE SESSIONS WILL BE REPEATED.

931ST ANNUAL STATEWIDE SUMMER CONFERENCE FOR KANSAS SCHOOL NURSES

BREAKOUT SESSION

DESCRIPTIONS

Addressing Child Obesity in Rural Schools: the iAmHealthy Program

Rural communities are disproportionally affected by obesity and its negative health consequences. Schools are a natural setting to influence the health and wellbeing of children and the greater community. This presentation will address current school-based research in rural Kansas schools (iAmHealthy Program) and other tools schools can use to impact overweight and obesity in their community.

Kelsey Dean, MS, RD, LD, CCRP, Clinical Trials Coordinator, Department of Pediatrics, University of Kansas Medical CenterMeggie Murray, MS, RD, CCRP, Study Coordinator, Dietitian, University of Kansas Medical Center

Child Find and Nurses' Responsibility

Session description to be announced.

Kimber Kasitz, BSN, RN, NCSN, KSNO President, Director of Health, Homebound & 504 Services, USD #259 Wichita

This session will cover creating a team approach for evaluation and treatment, ensuring that the student returns to learn as soon as possible.

Jill Kouts, MSM, BSN, RN, Clinical Program Coordinator, Center for Concussion Management, The University of Kansas Health System

Concussion: Coordinating Care Through the Chaos

Construction Zone: Building a Trauma-Informed Care Approach from Foundation Up

Understanding trauma-informed care and putting it into practice are two different things. This training is focused on providing information on what it means to be trauma-informed and how to build a personalized trauma-informed care approach. Being a trauma-informed health-care professional includes: understanding how trauma effects the everyday functioning of a person, doing your part to build resiliency in yourself and others, being attuned to your own trauma, and proactively taking care of yourself. During this interactive training you will be given tools for your toolbox that will allow you to build your own personalized trauma-informed care approach.

Bailey Bennett, MSN, Director of Nursing, KVC Hospitals, Children's Psychiatric TreatmentSara B. Schlagel, LSCSW, Director of Program and Staff Development, KVC Hospitals, Children's Psychiatric Treatment

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10 31ST ANNUAL STATEWIDE SUMMER CONFERENCE FOR KANSAS SCHOOL NURSES

BREAKOUT SESSION

DESCRIPTIONS

The session will be an interactive lecture of the basics of diabetes pathophysiology and typical treatments. We will focus on newly available technologies and how they impact the care of students at home and school.

Ryan McDonough, DO, FAAP, Co-Medical Director, Children’s Diabetes Center, Children’s Mercy Kansas City

Diabetes Technologies at School: What is That Thing on Your Hip, and What am I Supposed to Do With It?

This session will demonstrate the functionality of the KSWebIZ school module. It will provide training on all school module functionality, including: searching the system for students, printing a Kansas Immunization Certificates (KCI), enrolling and unenrolling students to a roster, school roster file import, sending immunization information electronically, and the reminder recall report.

Dylan Hart, KSWebIZ Technician/Trainer, Kansas Immunization Program, Kansas Department of Health and Environment

KSWebIZ School Module

Meal Modifications in School Meal Programs

This session will cover policy guidance regarding meal modifications and the requirements related to providing meals for children with special dietary needs in School Nutrition Programs.

Holly Steinlage, MPH, RD, LD, Child Nutrition Consultant, Child Nutrition & Wellness, Kansas State Department of Education

School Nurses on the Front-Line of the Vaccine War

Childhood immunizations have been so effective that an increasing number of parents believe that vaccine preventable diseases are mild or “natural” and that vaccines are no longer necessary. In the past 10 years, the number of parents refusing vaccinations or choosing alternative vaccination schedules has increased. As vaccine rates have declined and cases of vaccine-preventable diseases has increased, access for parents to reliable information about the safety and efficacy of childhood immunizations becomes even more important. Since all fifty states require specific vaccines for school-age children, schools are becoming “ground zero” for the anti-vaccine dispute. School nurses are perfectly positioned to educate students, families, and school staff about the critical role of vaccines. Attendees of this session will learn better ways of talking to parents who are vaccine-hesitant, including listing to and responding to their questions, and gaining their trust.

Gretchen Homan, MD, Associate Professor, Division of Ambulatory Pediatrics, Director of Community Relations & Department Giving, Department of Pediatrics, KU School of Medicine-Wichita Sarah Irsik-Good, MHA, President & CEO, Kansas Foundation for Medical Care; Board Member, Immunize Kansas Coalition

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1131ST ANNUAL STATEWIDE SUMMER CONFERENCE FOR KANSAS SCHOOL NURSES

BREAKOUT SESSION

DESCRIPTIONS

Sharpen Each Other

Gail shares the story of her son Austin Box who died from an accidental prescription drug overdose. Through his story she promotes the understanding of addiction and outlines the dangers of opioid abuse. The presentation is meant to be informative as well as motivational. When Austin passed away, he was wearing a wristband with Proverbs 27:17 written on it. The Austin Box 12 Foundation motto and the title of the presentation comes from this verse.

Gail Box, M.Ed., President, Austin Box 12 Foundation

Telehealth for the School Nurse: Increasing School Nurse Resources through Technology and Project ECHO

This presentation will review the fundamentals of telehealth and highlight successful school-based telehealth models. Attendees will learn about telehealth issues that are essential for supporting successful telehealth programs and increasing students' access to specialty care in the school environment. Nurses will be guided in considering the numerous roles school nurses can adopt in school-based telehealth and ways they can inform telehealth policy in their local school districts. Project ECHO will be introduced as a telementoring approach to increase professional networking, promote collaborative learning and community team building, and earn no-cost CNE in relevant nursing topic areas.

Jan Lyon, Project Manager, University of Kansas Medical Center Project ECHOShawna Wright, PhD, LP, Associate Director, KU Center for Telemedicine & Telehealth

A broad discussion with school nurses in the management of eye or vision conditions of students. We will be diving into the following topics: vision terminology; brief review of screenings and new guidelines; re-sources for comprehensive exams and materials; vision development; vision demands in the classroom; visual impairments; and managing red eyes of students.

Stacy Clark, OD, Diplomate, American Board of Optometry

The Eyes and Vision in School

The Role of the School Nurse in Creating a Vape-Free School

The school nurse has unique expertise to help combat the youth e-cigarette epidemic. An overview of how e-cigarette companies have targeted youth will be presented. Most of the session will focus on ways the school nurse can provide leadership in creating vape-free schools. This session will be based on the article of the same title which has been accepted for publication in the NASN School Nurse journal.

Lisa Frey Blume, BA, Training & Outreach Coordinator, Bureau of Health Promotion, Kansas Department of Health and Environment

Triaging Children with Symptoms of Chest Pain, Palpitations and Syncope

In this session, participants will discuss how to assess, evaluate and triage children in the school setting for symptoms of chest pain, palpitations and syncope.

Jenny Ecord, APRN, Neonatal and Pediatric Nurse Practitioner, Children's Mercy Specialty Clinic - Heart CenterArif Hussain, MD, Pediatric Cardiologist, Children's Mercy Specialty Clinic - Heart Center

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12 31ST ANNUAL STATEWIDE SUMMER CONFERENCE FOR KANSAS SCHOOL NURSES

BREAKOUT SESSION

DESCRIPTIONS

Unleash the School Nurse! Every Body should be a Healthy Body!

A variety of innovative components of School Wellness programs will be covered. The knowledge and expertise of the school nurse can put you in a position to make a positive impact on your students, staff and community. This is your chance to learn the role of the school nurse in a School Wellness program. Many creative ideas will be shared that can be replicated in your home school district.

Lorri Greenlee, MHCL, BSN, RN, Coordinator of Health Services, USD #465 Winfield

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1331ST ANNUAL STATEWIDE SUMMER CONFERENCE FOR KANSAS SCHOOL NURSES

CONFERENCEINFORMATION

REGISTRATION, FEES & REFUNDSThe New School Nurse Orientation registration fee includes all live sessions on Monday, July 20, presentation materials, and 30 days of access to the session recordings. For CNE credit, all New Nurse sessions must be viewed and evaluated by August 20, 2020.

The General Session registration fee includes all live sessions on July 21-23, 2020, presentation materials, and 30 days of access to the session recordings. For CNE credit, all General Session sessions must be viewed and evaluated by August 23, 2020.

The Premium Pass must be purchased in conjuction with General Session registration and includes access to the General Session recordings through October 23, 2020. Attendees will have 90 days following the conference to earn an additional 5.4 contact hours, or the equivalent of three breakout sessions. For CNE credit, all the three additional breakout sessions must be viewed and evaluated by October 23, 2020.

A form of payment must accompany your registration form. School districts that are unable to pay until after July 1 may register early by completing the registration form and sending it in along with a purchase order. Please confirm with your district that they have mailed your registration.

There will be no refunds issued for the virtual conference. You will receive a confirmation email within 1-2 days of the receipt of your registration form. If you do not, please contact Teruko Mitchell, Conference Registrar, at (316) 978-6493. The KSN Conference is being facilitated by the Wichita State University Office for Workforce, Professional and Community Education.

Please mail your completed registration form and check or purchase order (made payable to the Office of University Conferences) to:

Office for Workforce, Professional and Community EducationWichita State University1845 Fairmount, Campus Box 136Wichita, Kansas 67260-0136

Fax: (316) 978-3064

You may also register online at www.wichita.edu/conferences/ksn.

By participating in the Kansas School Nurse Conference, you give the Kansas School Nurse Planning Committee and Wichita State University the right to take photos and use your image in future promotional materials.

ACCOMMODATIONSThere will be no accommodations provided as this is a virtual conference.

Right of Termination for CauseThis agreement and the University’s obligations hereunder regarding this conference and the presentation of any or all associated sessions and optional entertainment events are subject to acts of God, war, terrorism, government regulations, disaster, fire, strikes, civil disorder, curtailment of transportation facilities, or other similar cause beyond the control of the parties making it inadvisable, illegal, or impossible to hold the event or provide the facility. If the conference or any associated event is canceled due to one of the aforementioned occurrences, the liability of the University shall be limited to refunding the conference registration fee or a portion thereof. The University shall not be responsible for consequential damages, including, but not limited to, any losses incurred by registrants including, but not limited to, airline cancellation charges, hotel deposits and other associated travel costs.

Special AccommodationsThe Kansas School Nurse Conference Planning Committee is committed to making programs accessible to people with disabilities. If you wish to volunteer information regarding any special assistance you may need, please contact the Office for Workforce, Professional and Community Education at (316) 978-6493.

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REGISTRATIONFORM

Name (as it appears on your nursing license) __________________________________________________________________________________________________________________

Home Address ____________________________________________________________________________________________________________________________________________________________________

City ___________________________________________________________________ State __________ Zip __________________________________________

Home Phone ___________________________________________________________________ Business Phone ___________________________________________________________________

Business E-mail ____________________________________________________________________________________________________________________________________________________________________

Other E-mail (that will be monitored over the summer) _____________________________________________________________________________________________________

USD # and Name or County Health Dept. ___________________________________________________________________________________________________________________

Business/Billing Address _________________________________________________________________________________________________________________________________________________

City ___________________________________________________________________ State __________________ ZIP _________________________________________

County: _________________________________ License Type & Nursing License # (required) _________________________________________________________

Are you a first time attendee? ______ yes ______ no

Are you a KSNO Member? ______ yes ______ no

KSNO Membership Number (required for discount) ________________________________________________

Registration Options:

______ New School Nurse Orientation (does not include General Session) $100 $______________

______ General Conference (KSNO Members) $150 $______________

______ General Conference + Premium Pass (KSNO Members) $215 $______________

______ General Conference (non-members of KSNO) $200 $______________

______ General Conference + Premium Pass (non-members of KSNO) $265 $______________

TOTAL AMOUNT ENCLOSED OR NOTED ON PURCHASE ORDER $______________

Payment method: ______ Check ______ Purchase Order ______ Visa ______ MasterCard ______ AMEX ______ Discover

CC# ____________ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ___ Security Code ______________ Exp Date _________________

Name as printed on the card ____________ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ _______________________________________

Signature ____________ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ _______________________________________________________________________________ ______ ______ ___

Register online at www.wichita.edu/conferences/ksn or complete the form below and mail or fax to:

Office for Workforce, Professional and Community EducationWichita State University1845 Fairmount, Campus Box 136Wichita, Kansas 67260-0136

Fax: (316) 978-3064