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REGISTRATION FORM Register Online at www.riskinformation.com

or Fill Out This Form and Send It With Payment Today To: Property Insurance Report National Conference 33765 Magellan Isle, Dana Point, CA 92629 Tel: 650 868-8990 • Fax: 949 481-3785 Email: [email protected]

First name Name:_______________________________ for badge:__________________ Title:____________________________________________________________ Company Name:___________________________________________________ Address:_________________________________________________________ City, State, Zip:____________________________________________________ Phone:___________________________ Cell phone:_____________________ Attendee email:____________________________________________________ Assistant email:____________________________________________________ Shirt Size Please Circle QUANTITY TYPE

1

Mens / Womens

XS

S

M

DESCRIPTION

PIRNC17 Conference Registration SubDisc Subscriber/Prior Attendee Discount Earlybird Earlybid Discount (pay by 8/1/17)

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XL

2XL

3XL

PRICE

AMOUNT

$1,799.00 -$100.00 -$100.00

$1,799.00

TOTAL:

Please submit one form for each attendee To pay by check, make checks payable to Risk Information Inc. (Tax ID 33-0778701) To pay by credit card, please fill out the information below: Name on Card: ______________________________________________________________________ Billing Address: _____________________________________________________________________ City: ___________________________________________ State: ______ Zip:___________________ Visa Master Card American Express

Card Number: Security Code: __________________ Expiration Date: ________________

Refunds will be made for cancellations through October 8, 2017. All refunds made by check. Cancellations between October 9 and October 15, 2017 will be subject to a $300 cancellation fee. No refunds for cancellations after October 15, 2017. Substitutions to enrolled delegates may be made at any time. Signature: _____________________________________________________ Date: _______________________ To reserve your sleeping room online, visit our web site: www.riskinformation.com Or contact The Ritz-Carlton, Rancho Mirage at (800) 542-8680 and reference group code ABGABGA Identify yourself as an attendee of the Property Insurance Report National Conference



Phone (760) 321 -8282, Fax (760) 321-1959 68900 Frank Sinatra Drive, Rancho Mirage, CA 92270 www.ritzcarlton.com/ranchomirage

From high atop a bluff where the eye can see as far as the imaginaQon will allow, The Ritz-Carlton, Rancho Mirage rekindles the spirit of one of Palm Springs’ premier luxury hotels with a bold transformaQon that sQll embraces the desert resort’s enduring casual elegance. Less than two hours away from San Diego and Los Angeles, the resort is truly worlds away from ordinary; a luxury retreat where guests can surrender to the serenity of a relaxing spa, indulge in fine dining, or follow the pros to one of the more than 100 world-class golf courses that have made Palm Springs one of the world’s top golf desQnaQons. And much like the desert sunrises and sunsets leave a colorful imprint on the surrounding mountain ranges and Coachella Valley below, The Ritz-Carlton, Rancho Mirage leaves a sensory impression that will stay with you forever.

To make a guest room reservation visit www.riskinformation.com, or you may use this link: Group Rate for PIRNC2017 Or you may call (800) 542-8680, and reference Group Code ABGABGA. **Due to high demand, reservaQons are encouraged to be made at your earliest convenience. 
 Room Reserva*on Deadline is Monday, October 16, 2017. Rate for a Deluxe Room is $299.00 per night. The hotel rooms are non-smoking. Group Room Rate will be available from Wednesday, November 8, 2017 through Thursday, November 16, 2017 on a space available basis. Rooms are only available to registered conference a5endees. Deposit and Cancela*on Policy: A credit card is required as a guarantee to confirm a reservaQon. Should The Ritz-Carlton, Rancho Mirage not receive the credit card guarantee, the reservaQon will not be confirmed. There is a seven (7) day prior to arrival cancellaQon policy. All reservaQons cancelled within seven (7) days of arrival will forfeit first and last night room rate. Reserva*on Cut-Off: Rooms will be held for the a\endees of the Property Insurance Report NaQonal Conference at this special rate unQl October 16, 2017, or unQl the reserved block fills. At that Qme, reservaQons will be accepted on a spaceavailable basis at the prevailing rate.