Convergence Cancellation Request

Convergence 2026

Registration Cancellation Request Form

Use this form to request the cancellation of one or more items from your Convergence conference registration.

Use this form if you are:

Attendee Information

First Name *

Last Name *

Email *

Phone *

What Are You Cancelling?

Cancelling (Check all that apply): *

Entire Registration

CVP (Convergence Value Package)

Session

Tour

Meal

Juror's Talk

Special Event

Day Pass

Details

Please provide the name(s) of the item(s) being cancelled (include session title, tour name, meal, date, etc.): *

Cancellation & Refund Policy

Please review:

Policy Acknowledgement: *

I acknowledge and agree to the cancellation and refund policy.

Refund or Donation Preference

If a refund is due, please select one: *

Issue my refund to the original form of payment.

Convert my eligible refund to a tax-deductible donation to HGA.

If converting to a donation (You will receive a donation acknowledgement for tax purposes.):

Convert my entire eligible refund.

Convert a portion of my eligible refund.

Donation amount:

Signature

By submitting this form, I confirm that the information provided is accurate and that I understand and agree to the policies above.

Typed Name: *

Date: *