PAGE 1-2 - 2017 Annual Mtg Reg Form v May5 · REGISTRATION FORM Note : Because this meeting is in...

REGISTRATIONFORMNote:BecausethismeetingisinEuropeweareaskingforyourcellphonenumber.Inaddition,thebulkofyourregistrationinformationwillbemailedtoyourhomeaddressunlessotherwiseindicated.

RegistrantInformationName_____________________________________________NameonBadge_______________

ArrivalDate________________________________DepartureDate________________________

Firm/CompanyName_____________________________________________________________

BusinessAddress__________________________________________________________________

City_________________________State_____________Zip___________Country___________

BusinessPhone__________________________CellPhone________________________________

Emailaddress______________________________________

HomeAddress:____________________________________________________________________

City:______________________________State:________Zip:_____________Country:________

U.S.StateBarNumber(s)ForAllStatesWhereLicensed:___________________________________

IsthisyourfirstmeetingasanFDCCMember: Yes NoIsthisyoursecondmeetingasanFDCCMember: Yes NoIsthisyourthirdormoremeetingasanFDCCMember: Yes No

Spouse/SignificantOthername______________________________________________________

NameonBadge_________________________CellPhone________________________________

Spouse/Significantotheremailaddress:_______________________________________________

Pleaselistalladultguestsattendingwithyou:

Nameonbadge Relationshiptoregistrant Address(ifdifferentthanmember)*_______________________ ____________________ ______________________________

City_________,State____Zip______

_______________________ ____________________ ______________________________

City_________,State____Zip______

_______________________ ____________________ ______________________________

City_________,State____Zip______

* Unlessotherwiseindicatedregistrationinformationwillbeshippedtothemember’saddress

Pleaselistallchildrenundertheageof21attendingwithyou:

Nameonbadge Birthday T-shirtsize_______________________ __/__/____ sm____med____lrg____xl____

_______________________ __/__/____ sm____med____lrg____xl____

_______________________ __/__/____ sm____med____lrg____xl____

MeetingInformationandFeesMember/Non-Member,Corporate,Spouse/SignificantOther/AdultGuest/AdultChild:Feeincludesbreakfasts,allreceptionsincludingtheWelcomeReception,President’sReception/DinnerThemeParty,andtheMasqueradeBall.Children16–20:Feeincludesbreakfast,WelcomeReception,ThemePartyandtheMasqueradeBall.Childrenundertheage16:Feeincludesbreakfasts,theWelcomeReception,andThemeParty.Note:AllchildrenarewelcometoattendthePresident’sReceptionandDinnerinGruyereforanadditionalfeeof$125.00.

RegistrationCategory Cost SelectDefenseCounselMember/Non-MemberLawyer $1775 ___________CorporateCounsel $695 ___________Spouse/Companion/ChildrenOver21 $750 ___________Children16-20 $495 ___________Children12-15 $425 ___________Children4-11 $260 ___________Children3andunder Complimentary ___________

Pleasenote: IfbothspousesareFDCCmembers,theymaypayoneMemberFeeandOneSpouse/Companionfee.Ifpayingbycheckpleasededuct$85fromthetotalamountdue.

Events:Date Time Event Price/Person #of Total$

ParticipantsMon.7/24 6:00-8:30pm WelcomeReception Complimentary _____ _CompWeds.7/26 5-10pm President’sRecp/Dinner Adults:Comp _____ _CompWeds.7/26 5-10pm President’sRecp/Dinner Children0-3 _____ _CompWeds.7/26 5-10pm President’sRecp/Dinner Children4-20: _____ $125_Thurs.7/27 5:00-9:30pm ThemeParty Complimentary _____ _CompThurs.7/27 9:30-11pm DessertParty Complimentary _____ _CompFri.7/28 6:30-11pm MasqueradeBall Complimentary _____ _CompFri.7/28 6:30-11pm MasqueradeBall Children16-20 _____ _Comp

ParentsareresponsibleforchildrenatthePresident’sReceptionandDinner

14kGoldConventionCharmCost #ofCharms Total$$140 __________ _________

ZurichActivities:Date Time Event Price/Person #of Total$ #NonSummit

Participants ParticipantsMon7/24 6:00am TransportationtoZurich $85 _______ _____ _____

RoundtripTransfer.OpentoallattendeesMon7/24 9:00am-12pm BridgingtheGapInsurance Comp _______ _Comp _____

SummitMon7/24 10am-2pm WalkingTourofZurich $95 _______ _____ _____

w/lunch.OpentoallattendeesBusesleaveat6am

Mon7/24 12pm-2pm LunchCruiseonLakeZurich $95 _______ _____ _____OpentoattendeesofSummitonly

Mon7/24 2pm TransportationtoMontreux $55 _______ _____ _____OnewaytransferfromZurichtoMontreuxOpentoallattendees

Activities:Date Time Event Price/Person #of Total$

ParticipantsSun7/23 3pm-4pm GuidedTourofFairmont $30 _______ _____

LeMontreuxPalaceMon7/24 9:30am-12pm GuidedTourofChateau $65 _______ _____

deChillonMon7/24 1pm-3pm LunchCruiseonLakeGeneva $180 _______ _____Mon7/24 2pm-3:00pm GuidedTourof $30 _______ _____

FairmontLeMontreuxPalaceTues.7/25 10am-4pm GlacierTour $215 _______ _____

w/boxedlunchTues.7/25 10am-4pm GuidedTourofOldTownBern $155 _______ _____

w/lunchTues7/25 10am-4pm GuidedTourofLausanne $170 _______ _____

&ShoppingExcursionw/lunch

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Weds7/26 10–11:30am ABookClubinMontreux N/C _______ _____Weds7/26 1pm-3pm LunchCruiseonLakeGeneva $180 _______ _____

w/lunchWeds7/26 1:30pm-4pm WineTastingTourofLavaux $175 _______ _____Weds7/26 1pm-3:30pm AlpineHike $215 _______ _____Weds7/26 1:30pm-4pm GuidedTourofChateau $65 _______ _____

deChillonThurs7/27 9am-10am Spouse/GuestHospitality N/C _______ _____Thurs7/27 12:30-3:30pm AStrollw/Hemingway N/C _______ _____Thurs7/27 1:30-4:30pm Thenest;Nestle’sDiscovery $75 _______ _____

CenterThurs7/27 1:30-4:30pm ChocolateExcursion $105 _______ _____Thurs7/27 1:30-4:30pm OlympicMuseum $120 _______ _____Fri7/28 7am-8am FunRun N/C _______ _____Fri7/28 1:00-4:30pm RochersdeNaye $25 _______ _____Fri7/28 1:30pm-5pm AquaParc-Adults $104 _______ _____

Children6-17 $88 _______ _____Childrenunder5 N/C _______ _____

Fri.7/28 1:30-4:30pm OlympicMuseum $120 _______ _____Fri.7/28 1:30pm-4pm WineTastingTourofLavaux $175 _______ _____

Children’sActivities:Date Time Event Price/Person #ofParticipants AgeMon7/24 6:30am-5pm FDCCKidsDaycare N/C _______ _____Wed7/26 7:15am-12:15pm FDCCKids’Morning N/C _______ _____Wed7/26 4:30-10:30pm ChildrenandYouth N/C _______ _____

DinnerProgramThurs7/27 7:15am-12:15pm FDCCKids’Morning N/C _______ _____Fri7/28 7:15am-12:15pm FDCCKids’Morning N/C _______ _____Fri7/28 6:00pm-11pm ChildrenandYouth N/C _______ _____

DinnerProgram

Totals: RegistrationFees: $__________CharmFee: $__________ZurichActivitiesFee: $__________OptionalActivitiesFee: $__________ChildrenActivitiesFee: $__________

GRANDTOTAL(Pleasetotalallfeesincludingregistration,charmandactivities). $__________

PLEASEsendpaymenttotheFDCCorregisteronlineatwww.thefederation.org

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PaymentCheck/MoneyOrder(PayabletotheFDCCinUSD)-Ifpayingbycheckpleasededuct$85fromthetotalamountdue.

__AMEX __Visa __MasterCard

Number:_________________________________ExpirationDate:_________SecurityCode:________

NameonCard:___________________________________________________ZipCode:_____________

Signature:_____________________________________________________________________________

Pleasenote:theFDCCcannotregisteryouunlesstheproperpaymentismadewithyourregistrationform.AllfeesarelistedaboveandarepayableinU.S.Currency.PleaseseetheConventionCancellationPolicyforthefullrefundpolicy.Forquestionspleasecalltheregistrarat630.433.4517

FederationofDefense&CorporateCounsel,275N.YorkStreet,Suite401Elmhurst,IL60126/Phone:630.433.4517

ConventionCancellationPolicy:

Arefundofregistrationfeesless$85andanyapplicablecreditcardfeeswillbegiveniftheFDCCofficereceiveswrittennoticenolaterthanJune19,2017.

NorefundswillbegivenifnoticeofcancellationisreceivedbytheFDCCofficeafterJune19,2017.

Intheeventofspecialcircumstancessuchasillnessorunforeseenfamilyorprofessionalemergencies,thisrefundpolicymaybesuspendedormodified(baseduponthemember’swrittenrequest)onlybyactionofthepresidentuponrecommendationoftheConventionChair.Itishighlyrecommendedthatallregistrantsgettripcancellationinsurance.

PleasenotifytheFDCCofficebyemail(registrar@thefederation.org/regina@thefederation.org)onceyouhavecancelledyourhotelreservations.NeithertheConventionChairnortheFDCCofficehasauthoritytomodifythehotel’scancellationpolicy.

ChargespaidtotheFDCCforseparateevents/activitiesmayormaynotberefundedinwholeorinpart.Thedecisiontorefundthesewillbemadeonacase-by-casebasisbytheConventionChair.MembersseekingreimbursementforthesepaymentsmustsubmitawrittenrequesttotheConventionChair.

Thedecisiontorefundfeeswillbebased,inpart,onthetimingofthecancellationandwhetherthereareavailableconventionfundsfromwhichtomaketherefund.PleasenotethatrefundsofanypaymentstoindependentthirdpartiesfortoursandothereventsandservicesarenottheresponsibilityoftheFDCC.

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