Annual Convention Registration 2017 - Colorado Motor Carriers Association

Company

First Name*

Last Name*

Email*

Phone*

Format: 303-333-3333

Registration Type*

Deadline: September 15, 2017

Regular Registration After Deadline - $500
Non-Member Registration After Deadline - $600
One Day Package-Friday - $395
One Day Package-Saturday - $350

Will You Have a Spouse or Guest Attending?*

(Price: $325 - Includes all Meals and Entertainment)

Yes
No

First Name of Spouse or Guest

Last Name of Spouse or Guest

Spouse or Guest Attending

Price: $325.00

Will Additional Family Members be Attending (Ages 13-18)?*

(Price: $325 - Max of 2 - Price is per Person and Includes All Meals and Entertainment)

Yes
No

Family Members (Ages 13-18) Attending*

Price: $325.00 Quantity:

First Name of Family Member #1*

Last Name of Family Member #1*

First Name of Family Member #2

Last Name of Family Member #2

Any Children attending the Friday Night Children's Program?*

(Must be ages 3-12. Price: $15 per child - Price includes Children's Buffet and Entertainment)

Yes
No

Friday Night Children's Program (Ages 3-12)*

Price: $15.00 Quantity:

Name and Age of Each Child

Child's Name	Age

Exhibitor Booth - $450

(Requires Full Registration)

Yes Exhibitor Booth
No Exhibitor Booth

Do You Need Electricity?

Electricity Needed
No Electricity

Golf*

(Must be a Registered Attendee to Play Golf)

Number of Golfers

Name and Company of Each Golfer

First Name	Last Name	Company

Dietary Restrictions

Comments

Payment Method*

Only members can pay by check!

Credit Card
Check

Please complete the fields below and submit this registration form and send your check to: Colorado Motor Carriers Association, 4060 Elati St, Denver CO 80216

Billing Address*

City*

State*

Zip Code*

Mailing Address

(If Different From Billing Address)

Mailing City, State & Zip Code

Total

$0.00

Credit Card

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Registration Refund Policy

Refunds less $50 will be given for cancellations up to 7 business days before the event. No refunds for no-shows or late cancellations. Please note that the hotel has its own cancellation policy for room reservations.

Agreement of Terms

By clicking the REGISTER button below, I agree to pay the merchant.

2017 Annual Convention Registration

Registration Refund Policy

Agreement of Terms