Use a separate form for each person registering for the conference. Full Name. First name preferred for badge. Title. De
2015 NATOA ANNUAL CONFERENCE REGISTRATION FORM SEPTEMBER 8-11, 2015, San Diego, CA Please print or type. Use a separate form for each person registering for the conference Full Name First name preferred for badge Title Department Agency/Company Address City/State/Zip Telephone E-mail Full Conference Registration Full conference registration includes admission to all educational sessions, exhibits, luncheons, refreshment breaks, receptions and handout materials. It does not include optional activities or meals for guests. Full conference registration also includes a membership in NATOA for the balance of 2015. Registration Registration 6/04/15 After 7/10/15 until 6/03/15 until 7/10/15 NATOA Member $575 $650 $725 NLC Primary Member/Elected Official $575 $650 $725 Government Non-Member $845 $950 $995 Non-Member Private Sector $945 $1,045 $1,095 One or Two-Day Registration One or two-day registration includes that day’s concurrent educational sessions, refreshment breaks, any meals and handout materials. Optional activities are not included. You may register for one or two days, otherwise you must register for the entire conference. Wednesday Thursday Friday Registration (Per Day) NATOA Member: $275 NLC Primary Member/Elected Official: $275 Government Non-Member $375 Non-Member Private Sector $425 Optional Sessions: Please indicate the activity in which you wish to participate Tuesday 9/8 Annual Business Meeting: Please indicate your intent to attend the Annual Business Meeting - NC Tuesday 9/8 Rookies Boot Camp/First Time Attendees Meeting – NC Tuesday 9/8 4:30 pm Petco Park Stadium Tour – $12 Tuesday 9/8 7:00 pm Padres Baseball Game – includes food and non-alcoholic beverages - $37 Friday 9/11 All Day Storytelling Workshop featuring Les Rose - NC Payment Information Please note that actual payment must be received by the date indicated in order to receive the registration rate. If your registration form and payment are not received by the date indicated, the correct (higher) fee will be applied. A purchase order does not constitute payment.
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2015 NATOA ANNUAL CONFERENCE REGISTRATION FORM CONTINUED Registrant Name Family and Friends Guest Meals All meals for the registrant are included with full conference registration. If you have registered for the full conference, it is not necessary to purchase additional meals for yourself. All Meals (includes 3 breakfasts) $300.00 Thursday Luncheon $ 50.00 Wednesday Luncheon $ 50.00 Friday Luncheon $ 50.00 Wednesday Welcome Reception $ 50.00 Friday GPA Awards Banquet $ 80.00 Total Conference Payment Please include all categories checked, i.e., registration fees, seminars and extra meals Total: $ ____________________ Credit Card Information: If paying by credit card, fax this form to (703) 997-7080. You may also register via our web site at www.natoa.org VISA / MasterCard / American Express Credit card number Cardholder name
CCV Code Exp. Date
Signature If paying by check, return this form with payment to: NATOA, P.O. Box 826127, Philadelphia, PA 19182-6127 ACCOMMODATIONS FOR PEOPLE WITH DISABILITIES: NATOA wishes to ensure that no individual with a disability is excluded, denied services, segregated or otherwise treated differently from other individuals because of the absence of an auxiliary aid or service. If any auxiliary aid or service identified with the Americans with Disabilities Act is required, please contact NATOA Headquarters at
[email protected] or (703) 519-8035. SPECIAL DIETARY NEEDS: Please indicate here or email
[email protected] if you require special dietary needs, such as diabetic, kosher, vegetarian, gluten free, etc. Dietary requests such as Atkins or South Beach cannot be accommodated. Contact NATOA Headquarters at
[email protected] or (703) 519-8035 if you have any questions. ____________________________ Cancellation Policy Conference Registration: Full registration fee minus a 25% service charge will be refunded if cancellation is received in writing at NATOA Headquarters no later than Friday, August 7, 2015. No refunds will be made for cancellations received after August 7, 2015. Substitutions are permitted and encouraged in lieu of cancellation. You may fax your cancellation or substitution request to (703) 997-7080 or email
[email protected]. Tour Policies:
Indemnification: The attendee assumes responsibility for his/her own personal conduct and well-being traveling to, from and
during any tour event and will adhere to the set rules, including those regarding the consumption of alcoholic beverages. Participating in tours involves certain risks. The attendee consents to and assumes the risk of any mishaps. The attendee will exercise reasonable precaution to avoid excessive and/or unreasonable damage to tour equipment and facilities. Dress Code: Casual clothing and comfortable walking shoes are recommended for the baseball game. ADA Policy: It is the policy of our tour provider, in complying with applicable ADA regulations, to take all reasonable steps to ensure that all persons with disabilities are given equal and reasonable opportunity to access all tour services. To better serve your needs, please provide us with the details of any specific disability you or your guests may have, and we will endeavor to provide reasonable accommodation and access. Cancellation Policy: All optional activities must be pre-registered and paid in advance. On-site registrations will not necessarily be available as seating is limited. All optional activity registrations are considered final. Substitutions are permitted and encouraged in lieu of cancellation. You may email your Substitution Request to
[email protected] prior to August 25, 2015.
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