REGISTRATION FORM Register Online at www.riskinformation.com
or Fill Out This Form and Send It With Payment Today To: Auto Insurance Report National Conference 33765 Magellan Isle, Dana Point, CA 92629 Tel: 650 868-8990 Email:
[email protected]
First Name Name:____________________________ for Badge:__________________ Title:_________________________________________________________ Company Name:________________________________________________ Address:______________________________________________________ City, State, Zip:________________________________________________ Phone:__________________________ Cell Phone:___________________ email:________________________________________________________ Shirt Size Please Circle QUANTITY
1 1
Mens / Womens
XS
S
M
L
XL
TYPE
DESCRIPTION
AIR2019 Discount Earlybird
2019 Property Insurance Conference Subscriber & Prior Attendee Discount Earlybird Discount (pay by 1/31/19)
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 March 31, 2019. Cancellations between April 1 and April 5, 2019 will be subject to a $300 cancellation fee. No refunds for cancellations after April 5, 2019. Substitutions to enrolled delegates may be made at any time. All refunds will be paid by check. Signature: _____________________________________________________ Date: ____________________ To reserve your hotel room online, visit our web site: www.riskinformation.com Or contact The Breakers Palm Beach at 888-BREAKERS (888-273-2537). Identify yourself as an attendee of the Auto Insurance Report National Conference
Greetings, The Breakers looks forward to welcoming you to the Auto Insurance Report National Conference being held May 5-7, 2019. As you may know, The Breakers is one of America’s legendary resort locations. The Italian Renaissance-style hotel resides on 140 acres of oceanfront property in the heart of Palm Beach. To reserve your room at The Breakers, please visit https://book.passkey.com/go/RISK19 , or call 888-BREAKERS (888-273-2537) before April 2, 2019. The nightly group rate, available only to registered conference attendees, is $345 (plus tax) for a Deluxe Room. Information on other room categories is available on the website. The discounted room rate is available until April 2, or until the room block is filled, which is likely to be much sooner so please make your reservations as early as possible. The group rate is available 3 days before and 3 days after the meeting dates on a space and rate available basis. Each room reservation will require a deposit equivalent to your (1) one-night room rate (based on selected room category) to guarantee your reservation. In the event you must cancel your reservation, kindly do so at least 7 days prior to your arrival date to avoid forfeiture of the deposit. If a reservation is reduced in length of stay within the cancellation period, a penalty fee applies. Failure to arrive on the scheduled date will result in cancellation of your reservation and forfeiture of deposit unless the hotel receives prior notification. Please notify the hotel of an early departure at check-in. Failure to do so will result in the loss of your deposit. Check-in time is after 4:00 p.m. and check-out time is 12:00 noon. To avoid an additional room charge, please check out no later than 12:30 p.m. on the day of your departure. We look forward to a successful event and memorable visit to The Breakers! The Breakers Reservation Team
One South County Road | Palm Beach, Florida 33480 | P (561) 655-6611 | F (561) 659-8403 | thebreakers.com
