1. Military Spouse Day Conference 2012
General Information
WHAT: This 2-Day event is a salute to our Military Spouses!! It’s an event just for
you – meet other spouses, get to know yourself better, or just have fun!!
WHEN/WHERE: DAY 1 – Thursday, May 10 - “You Can Be Creative” - fun workshops
that will bring out the creative side of anyone. (Fort Bragg Club)
DAY 2 – Friday, May 11 - “Soldier for a Day” – an opportunity to experience a day in
the life of a Soldier to include morning physical training and the jump tower! BE
PREPARED TO GET DIRTY AND SWEATY – it’s definitely not a day for the physically
shy!! (Soldier Support Center/Other post locations).
TIME: 8:00 a.m. to 5:00 p.m. Both days - detailed agenda attached.
REGISTRATION FEE: $15 per day; $25 for both days. Payment made by check or money
order payable to “IMWRF”. Sorry, absolutely no refunds on cancellations after April 27.
CHILD CARE: Due to the nature of the conference, children will not be allowed to attend.
Limited child care is provided for conference attendees on both days who are current CYSS
cardholders. Children must be between the ages of 6 weeks and 12 years. Unfortunately,
after school care only cannot be provided unless there are available spaces remaining after
full day requirements are taken care of. Day 2 participants are reminded that prior
arrangements must be made for school age children as you will need to check in prior to 8
a.m. and not be able to leave the location until 5 p.m. (except in cases of emergencies).
Once child care reservations are made, no-show fees will be charged against the
participants CYSS accounts should the spaces not be used and not cancelled in advance.
CONFERENCE REGISTRATION DEADLINE: Friday, April 27 (or when available slots
are filled)
HOW TO REGISTER: Complete the attached registration form and drop off with your
registration fee to Army Community Service, Installation Volunteer Services, located on the
3rd Floor, Soldier Support Center, Normandy Drive. Additional registration packets can be
downloaded from the website at www.fortbraggmwr.com. Due to payment and release form
requirements, registration cannot be taken on-line.
FOR MORE INFORMATION: If you need additional information, contact Installation
Volunteer Services at (910) 396-8160.
REGISTRATION FORM & WORKSHOP INFORMATION ATTACHED.
2. MILITARY SPOUSE DAY CONFERENCE 2012 REGISTRATION FORM
___________________________________________________________________________
Last Name First Name Email (required for conference confirmation information)
___________________________________________________________________________________
Address City State Zip Code
__________________________________________________________________________________________________________________
Phone # Alternate Phone #
Need childcare? ___ Yes** ___ No **You must be a CYSS cardholder to use the child care. A no-show fee
will be charged to your account by CYSS if care is reservednot cancelled in advance.
Names/ages of children______________________________________________________________________
*Child care is full day only for children ages 6 weeks – 12 years of age.
YOU MAY SIGN UP FOR ONE OR BOTH DAYS - Registration fee is $15 for one day; $25 for both.
____ DAY 1 – Everyone Can Be Creative!
7:15 a.m. – 8:00 a.m. Registration**
7:30 a.m. – 8:30 a.m. Registration*
8:00 a.m. – 8:10 a.m. Welcome/Formation
8:30 a.m. – 8:45 a.m. Welcome/Overview
8:10 a.m. – 8:45 a.m. Physical Training (PT)
9:00 a.m. – 11:55 a.m. 8:45 a.m. – 10:30 a.m. Enroute to Training Area
___ Craft Round Robin (3 projects)
___ Self Defense Basics
OR 10:30 a.m –12:15 a.m. Enroute to Training Area
9:00 a.m. – 10:15 a.m.
___ Tasty Arrangements
___ Jewelry Making Basics 1** 12:15 p.m. – 12:45 p.m. Lunch on site
10:30 a.m. – 11:45 a.m. 12:45 p.m. – 2:30 p.m. Enroute to Training Area
___ Casual/Elegant Table Settings
___ Jewelry Making Basics 2**
2:30 p.m. – 4:15 p.m. Enroute to Training Area
12:00 p.m. - 1:30 p.m. Lunch – Lafayette Room
4:15 p.m. – 4:30 p.m. Return to Soldier Support
1:45 p.m. – 4:30 p.m. Center
___ Craft Round Robin (3 more projects!)
___ Tips for a Better Home/Garden 4:30 p.m. – 5:00 p.m.
OR All – Final Formation/Dismissal
1:45 p.m. – 3:00 p.m. *Times are approximate. ACTUAL SCHEDULE WILL BE
___ Line Dancing SENT TO PARTICIPANTS VIA EMAIL PENDING FINAL
___ Easy Cupcake Decorating COORDINATION WITH UNITS/FACILITIES; requires
completion of Release of Liability; participants must be
able to participate the entire day or arrange own
3:15 p.m. –4:30 p.m. transportation.
___ Zumba
___ Handmade Book Purses **Child care open at 7:15 a.m. for drop off
*Child care opens at 7:30 a.m. for drop-off SHIRT SIZE FOR DAY 2 ONLY! __________
(T-shirts are men’s sizes S-2XL only – every effort
is made to provide size requested. Sizes are NOT
FOR OFFICE USE ONLY guaranteed if registration is after April 27.
Date Form Received ___________________________
Staff Initials __________________________________
Amount Paid _____________Check/MO # _________
____ DAY 2 – Soldier for ____________________
Sponsor Unit/SSN on Check a Day*
Day 1 _______ Day 2 _______ Both Days ______
Release Form for Day 2 ________________________
3. Military Spouse Day Conference 2012 Workshop Descriptions
9:00 a.m. - 11:55 a.m.
Craft Round Robin – Complete three different craft projects – Rope Pots, Modge Bottles, & Beeswax Candles. Once
you learn the basics, can easily be adapted for kids as well!
9:00 a.m. - 10:15 a.m.
Self Defense (Part I) - Designed to teach you basic self defense moves and how you can protect yourself should the
need arise. 2 parts – must sign up for both.
9:00 a.m. - 10:15 a.m.
Tasty Arrangements – Learn how to make centerpieces or small arrangements using fruits and vegetables that you can
then eat!
Jewelry Making Basics (Part 1) - Ever see a great piece of beaded jewelry that you loved but wish it was different color,
or a different length? Make it yourself after learning the basics of simple beaded jewelry to keep for yourself or give as
gifts! 2 parts – must sign up for both.
10:30 a.m. - 11:45 p.m.
Self Defense (Part 2) - Continuation of Part 1 – must take both parts.
Casual to Elegant Table Settings – Learn how to use what you already have to create casual to more elegant
“tablescapes”!
Jewelry Making Basics (Part 2) - Continuation of Part 1 – must take both parts.
LUNCH – 12:00 p.m. – 1:30 p.m. – LAFAYETTE ROOM, FORT BRAGG CLUB
1:45 p.m. - 4:30 p.m.
Craft Round Robin – Complete three more craft projects – Shadow Boxes, Flower Letter Blocks, & Shoe Herb Planters.
Once you learn the basics, can easily be adapted for kids as well!
Tips for a Better Home & Garden – Learn basic, simple repairs that you can handle on your own without having to call
an expensive repairman such as leaking faucets, fuse boxes, etc.; and simple ideas to make outdoor work easier and
more productive.
1:45 p.m. - 3:00 p.m.
Line Dancing – Learn basic line dancing steps so you can be a part of the crowd at your next big event!
Cupcake Decorating – Learn basic techniques and simple ideas for decorating cupcakes.
3:15 p.m. - 4:30 p.m.
Zumba – it’s not about having perfect form – it’s all about getting a good workout and having fun!
Handmade Book Purses – Transform a hardback book into a purse you can use everyday!
4. RELEASE OF LIABILITY
Data Required by the Privacy Act of 1974
Prescribing Directive: 10 USC 2733, 28 USC 2671-2680, AR 27-20
Authority: Title 10, USC 3012. Principal Purposes: To release the United States Government, Department of the Army,
XVIII Airborne Corps, Installation Management Agency, Fort Bragg, and the agents and employees thereof from any and
all liability arising from or incident to participation in the 2012 Military Spouse Day Conference workshop activities and/or
“Soldier for a Day” event.
Mandatory or Voluntary Disclosure and Effect on Individual Not Providing Information: Voluntary; however, if information
is not provided, participation in the 2012 Military Spouse Day Conference workshop activities and/or “Soldier for a Day”
event.
************************************************************************************************************************
In consideration of the permission extended to me by the United States, through its agents, to participate in the 2012
Military Spouse Day Conference workshop activities and/or “Soldier for a Day” event, I __________________________
(print name) agree to release and hold harmless in the United States Government, the Department of Defense, the United
States Army, Fort Bragg and the agents and employees thereof from any and all liability for personal injury, death,
property damage or loss, or any other loss resulting from or arising out of my participation in the 2012 Military Spouse Day
Conference workshop activities and/or “Soldier for a Day” event on Fort Bragg, North Carolina.
Participation in the 2012 Military Spouse Day Conference workshop activities and/or “Soldier for a Day” event may
include, but is not limited to the risk of death or serious injury such as cuts, burns, muscle strains or other injury resulting
from the risks/hazards of physical training, engagement skills training, obstacle course, 34 foot jump tower, airborne
operations, and other related activities; or the conduct of other participants, including their negligence or willful
misconduct. Please note that spouses who are pregnant or suspect they may be pregnant may NOT participate in
the Soldier for a Day event.
I certify that I will abide by all safety rules and the direction of the 2012 Military Spouse Day Conference workshop
activities and/or “Soldier for a Day” event staff. I further acknowledge that failure to abide by all safety rules and the
direction of the 2012 Military Spouse Day Conference workshop activities and/or “Soldier for a Day” event staff may result
in my being disqualified from participating in the 2012 Military Spouse Day Conference workshop activities and/or “Soldier
for a Day” event on Fort Bragg.
I also agree to release the United States, the Department of Defense, and the United States Army from any and all
liabilities, claims and causes of action, based on or arising from negligence or gross negligence on the part of the United
States Army, Department of Defense, Fort Bragg, and its agents and employees.
I acknowledge that I have read and understand the provisions of this release and understand that it is binding upon
myself and my assigns, heirs, executors, beneficiaries, family members, and derivative claimants. I further acknowledge
that I am over the age of 18 and have no medical history or condition that would preclude me from participating in the
2012 Military Spouse Day Conference workshop activities and/or “Soldier for a Day” event on Fort Bragg.
_____________________________________________
Date
_____________________________________________________________________________________________
Printed Name of Participant
_____________________________________________________________________________________________
Signature of Participant
Date Received _______________________________________ Staff Member __________________________________________