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2011 Delegate Registration Form

Supplier and
Business Partner
Delegate Registrations:

I am a Supplier/Business Partner Delegate US $500 per person (discounts do not apply for these registrations)


You will be contacted about payment options once your registration is received.

Abilita
Delegate Registrations:

I am a Delegate US $1,050

A 10% discount on the US $1,050 fee will be applied when payment is received before October 1, 2011. This discount does not apply on subsequent delegate registrations or spouses.

I am a Subsequent Delegate from my office or licence group - please apply the US $225 discount.

I am a Spouse US $100 (social activities only)

Discounts apply for Abilita delegates only and who have reservations at the Omni.

Your total fee will be invoiced separately upon receipt of your completed registration.

First Name:

Last Name:
Confirmation Email Address:
(if you don't receive a confirmation email,
your registration was not received at Abilita)
Badge Name:

Special Dietary Requirements:
(i.e. vegetarian)

Apparrel Size:
(Abilita Delegates only)
Please indicate your golf shirt size.

Ladies -

Mens -

Arrival Date:
Departure Date:
I am staying at The Mayfair Hotel and Spa

Yes

No
I am sharing a room with:
(provide name)
Golf:
Please indicate whether you will play golf on Wednesday, October 26, 2011.
The cost of golf is not included in the registration fee.