Professional Registration (We Welcome Members of AAPG, AIPG, SEG, SPE, APGE, $ Ea. NO. TOTALS AWG, OCGS, SEPM, SIPES, SPWLA, & TSOP), and all Mid-Continent Section Societies

~ Event Fee Per Professional: BEFORE August 15, 2017: $ 290.00 [____] $_______AFTER August 15, 2017: $ 395.00 [____] $_______

1 Day Registration: [___] Monday or [___] Tuesday $ 215.00 [____] $_______ On-site Registration, per day: $ 225.00 [____] $_______

~Spouse / Guest Registration: $ 65.00 [____] $_______

Students, with AAPG Membership: No Cost [____] $_______Students, Non-Member of AAPG: $ 25.00 [____] $_______Workshops, Saturday, Sep. 30th and Sunday, Oct. 1st:

ProfessionalCost|Teacher&StudentCost~ Geochemistry: Tool for Evaluating Unconven. Plays; Sat., Sep. 30th: $100.00 | $25.00 [____] $_______~ Basic Completion and Stimulation for Geologists; Sat., Sep. 30th: $250.00 | $25.00 [____] $_______~ Reservoir Engineering for Geologists; Sat., Sep. 30th & Sun., Oct. 1st: $300.00 | $25.00 [____] $_______~ Geological Reservoir Characterization and Modeling; Sat., Sep. 30th: $100.00 | $25.00 [____] $_______~ Mid-Continent Core Lab; Sat., Sep. 30th (Including Lunch): $150.00 | $30.00 [____] $_______~ Petrophysics of Unconventional Reservoirs; Sun., Oct. 1st: $250.00 | $25.00 [____] $_______~EnhancedImageryAnalysisforIncreasedEfficiency;Sun.,Oct.1st: $100.00 | $25.00 [____] $_______~ Fluvial Sedimentology and Geomorphology; Sun., Oct. 1st: $200.00 | $25.00 [____] $_______

Field Trips, on Saturday, Sep. 30th:~ Field Geology of the Arbuckle Mountain Area: $ 95.00 | $25.00 [____] $_______~ Historical Places and People of Oklahoma Oil: $ 95.00 | $25.00 [____] $_______

Luncheons:~ All-Convention Luncheon, with Lorenzo Simonelli, President and CEO,

$ 45.00 | $35.00 [____] $_______ Baker Hughes, a GE company; Mon., Oct. 2nd: ~ DPA Luncheon, with Claudia J. Hackbarth, VP, Unconventional Technology and Shell TechWorks; Tue., Oct. 3rd: $ 45.00 | $35.00 [____] $_______

Social Activities:~ Post Icebreaker Social, Bricktown Brewery, with Entertainment by Michael Kleid (on the Sax and Piano); Sun., Oct. 1st: $ 45.00 For All [____] $_______~ Monday Evening Reception, Wine Tasting, Dinner and Entertainment by Travis LeDoyt (Elvis Tribute Artist); Mon., Oct. 2nd: $ 85.00 For All [____] $_______

Spouse / Guest Activities, Including Transportation:~ Oklahoma River Boat Cruise and Lunch; Mon. Oct. 2nd: $ 65.00 For All [____] $_______ ~ The Myriad Botanical Gardens Tour with Lunch at Vast Restaurant (Top of Devon Energy Tower); Tue., Oct. 3rd: $ 50.00 For All [____] $_______

TOTAL$:

2017 AAPGMid-Continent Section Meeting

Meeting Costs & Registration Form {Please Use A Separate Registration Form For Each Registrant}Pre-RegistrationandOn-Site

Registration,Includes:

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~ Admission to the Meeting, Saturday - Tuesday, Sep. 30th - Oct. 3rd, 2017 ~~ The Icebreaker, Opening Session, and Awards Ceremony, Sunday, Oct. 1st ~

~ The Beerfest, Monday, Oct. 2nd; AND, The Post Convention Cocktails, Petroleum Club, Tuesday, Oct. 3rd ~

DISCLOSURE AND DISCLAIMERBy registering and attending the 2017 AAPG Mid-Continent Section Meeting (the “Meeting”), I, along with my spouse and/oranyguest(s)soidentifiedonthisPre-RegistrationForm,foreverreleaseandagreetoindemnifyandholdharmless,the AAPG Mid-Continent Section, the American Association of Petroleum Geologists, the Oklahoma City Geological Society,Inc.,andtheOklahomaCityGeologicalFoundation,(hostorganizations)andtheagents,officers,servants,andemployers of each entity, from all liability and for any loss, damage, or injury sustained by me, my spouse, and/or any guest(s),ifsoidentifiedonthisPre-RegistrationForm,whileinvolvedwith,inanyway,mannerorform,theMeeting.

Please do one of the following to complete the registration process: • Copy the form, and mail it along with either your check or Credit Card information to

Debbie Hoose, c/o: K. Stewart Exploration, 3317 E. Memorial Road, Suite 200, Edmond,OK 73013;

• Scan both pages of this Form and Email them to: dhoose@coxinet.net; or• Fax both pages of this Form to: (405) 285-4129

Member Name___________________________________ Society_____________ Member # ______

Company__________________________________________________________________________

Spouse | Guest Name(s)_______________________________________________________________

Address___________________________________________________________________________

City____________________________________________ State:_________ Zip Code:____________

Telephone____________________________________ Fax__________________________________

E-mail_____________________________________________________________________________

[___] Check Enclosed (PayableTo:2017AAPGMid-ContinentSectionMeeting):

[___] Charge My Credit Card, #__________________________________________________ Exp.______|______

3 or 4 Digit, Card Security Code_____________________ Billing Zip Code__________________________

2017 AAPGMid-Continent Section Meeting

Meeting Costs & Registration Form {Please Use A Separate Registration Form For Each Registrant}

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