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REGISTRATION FORM Note : Because this meeting is in Europe we are asking for your cell phone number. In addition, the bulk of your registration information will be mailed to your home address unless otherwise indicated. Registrant Information Name _____________________________________________ Name on Badge _______________ Arrival Date________________________________ Departure Date________________________ Firm/Company Name _____________________________________________________________ Business Address__________________________________________________________________ City _________________________ State _____________ Zip ___________ Country ___________ Business Phone__________________________ Cell Phone________________________________ Email address ______________________________________ Home Address: ____________________________________________________________________ City: ______________________________ State: ________ Zip: _____________ Country: ________ U.S. State Bar Number(s) For All States Where Licensed: ___________________________________ Is this your first meeting as an FDCC Member: Yes No Is this your second meeting as an FDCC Member: Yes No Is this your third or more meeting as an FDCC Member: Yes No Spouse/Significant Other name______________________________________________________ Name on Badge_________________________ Cell Phone________________________________ Spouse/Significant other email address: _______________________________________________

PAGE 1-2 - 2017 Annual Mtg Reg Form v May5 · REGISTRATION FORM Note : Because this meeting is in Europe we are asking for your cell phone number. In addition, the bulk of ... Zurich

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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([email protected]/[email protected])onceyouhavecancelledyourhotelreservations.NeithertheConventionChairnortheFDCCofficehasauthoritytomodifythehotel’scancellationpolicy.

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

Thedecisiontorefundfeeswillbebased,inpart,onthetimingofthecancellationandwhetherthereareavailableconventionfundsfromwhichtomaketherefund.PleasenotethatrefundsofanypaymentstoindependentthirdpartiesfortoursandothereventsandservicesarenottheresponsibilityoftheFDCC.

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