Registration Form

2014 CRWUA Conference Information _________________________________________________________________________________ Preregistration Fee Preregistration is $425 if paid by November 30. This includes registration fee to the conference; one Thursday caucus breakfast meeting and one Thursday lunch; as well as entry to the Percolation and Runoff that Thursday evening. Retiree preregistration is $213 if paid by November 30 and includes the same as above. You are considered a retiree only if you are fully retired and paying your own way. If a district, association or organization is paying your registration fee, you are not considered a retiree for this purpose. Please send your completed Preregistration Forms and check or credit card authorization to: ? 1001 S. Valley View Blvd., MS 760, Las Vegas, NV 89153 NOTE : There is no single-day registration. Fee is for one and all events. Registration fee does not include hotel accommodations. Online Registration Preregistration is also available on-line by visiting CRWUA's web site at: www.crwua.org If you are paying by check, you are still encouraged to register on-line and select “check” as your payment option. Membership Dues Individual membership dues are $20 and must be paid to attend the conference. Organizational dues do not apply. Preregistration Deadline November 30 is the deadline for preregistration discount. After that date, on-site registration is $450 or if retired, $238, and may be paid by check or credit card (VISA or MasterCard). All preregistrations must be received by November 30. After that date, registration must be made on-site. Meals Additional Thursday luncheon tickets may be purchased. Preregistration cost: $50.00. On-site cost: $55.00 Breakfast tickets are not available for purchase. The caucus breakfast is a business meeting and only current, paid members may attend. Spouses/Guests Activities for spouses/guests will be provided. On Thursday morning, there is a continental breakfast and a program. There is no charge for these functions. However, spouses/guests must indicate spouse registration on the form. Optional Tour There will be an optional tour to the Hoover Dam offered for an additional cost. Tour cost: $25 per person. There is limited space available on the tour. Tour may be cancelled based on interest; if tour is cancelled, refunds will be given. Cancellation / Refund / Substitution Policy Please e-mail all cancellation/refund/substitution requests to Mitch Bishop at mitch.bishop@snwa.com by November 30 or by fax at (702) 822-8530. Substitution requests after November 30 will be handled on-site. There is a processing fee of $75 on registration refunds after November 16. Refunds will be processed after the completion of the conference. No refunds after November 30. Hotel Reservations ? The first 300 room reservations are guaranteed in the Palace Tower at $105. After the first 300 reservations, rooms in other parts of the hotel may be reserved at $105. November 10 is the deadline for room reservations. ? Contact Caesars Palace directly at 1-866-227-5944 to reserve your room. Be sure to mention the Conference Code of SCCRW4. Questions: Call Mitch Bishop or Stacey Robb at (702) 258-3939, or e-mail them at mitch.bishop@snwa.com or stacey.robb@snwa.com Dates to Remember November 10 – Last day to reserve a hotel room at Caesars Palace and receive the group rate. November 16 – Final day to request a full refund. November 30 – Last day to request a refund, less $75 processing fee. November 30 – Last day to request substitutions. Deadline for preregistration. 2014 ANNUAL CONFERENCE Preregistration Form Caesars Palace • Las Vegas • December 10 - 12 Fill in completely – Please Print/Type Clearly Registrant ____________________________________________________ ______________________________________________________ (Name) (Name badge to read – FIRST NAME ONLY) Spouse/Guest _________________________________________________ ______________________________________________________ (Only if attending) (Name badge to read – FIRST NAME ONLY) Please indicate if your spouse/guest will be attending: ? Thursday, Continental Breakfast ? Thursday, Spouse/Guest Program Company ____________________________________________________________________________________________________________ Address _____________________________________________________________________________________________________________ City______________________________________________________________ State ________________________ Zip __________________ Phone _______________________________________E-Mail___________________________________________________________________ Amount Paid Preregistration Package Before Nov. 30 $425 $_____________ Includes registration, one Thursday caucus breakfast meeting and one Thursday lunch (Onsite - $450) ________________________________________________________________________________________________ Retiree Preregistration Package Before Nov. 30 $213 $_____________ Considered a retiree if fully retired and paying your own way. (Onsite - $238) If district, association or organization is paying registration fee, you are not considered a retiree for this purpose. Includes the same as above. ________________________________________________________________________________________________ Additional Thursday Lunch Tickets ______ (Quantity @ $50 each; Onsite @ $55 each) $50 $_____________ ________________________________________________________________________________________________ 2014 Individual Membership Dues $20 $_____________ If not previously paid. Membership dues are required to attend conference. Organizational dues do not apply. ________________________________________________________________________________________________ Optional Tour – Wednesday morning, Dec.10, Hoover Dam ______ (Qty @ $25 each) $25 $_____________ Reservation deadline – Nov. 30 ________________________________________________________________________________________________ Total $_____________ ? Visa ? MasterCard Card Number_____________________________________________ Expiration Date _______________________ ? AMEX ? Discover Cardholder Name ______________________________________________________________ (Please print) Cardholder Signature____________________________________________________________ (Must be signed to process credit card payment) Make check or money order payable to CRWUA. Return this form with payment to: Online Registration: Questions: Phone: CRWUA www.crwua.org Mitch Bishop – mitch.bishop@snwa.com (702) 258-3939 1001 S. Valley View Blvd., MS 760 Stacey Robb – stacey.robb@snwa.com Fax: (702) 822-8530 Las Vegas, NV 89153