January 7, 2009
JAMBOREE REGISTRATION
  2ND ANNUAL SALES JAMBOREE
BALLY’S LAS VEGAS
February 11 – 13, 2009
Registration

 

* Required Field

First Name *
Badge Name
Title
Address 1 *
Address 2 *
State * Zip *
Phone (cell preferred) *
Last Name *
Industry Designations
Agency / Company *
City *
E-mail *
Fax *

 

Emergency Contact Information
First Name *
Phone (Cell) *
Last Name *
Phone (Home) *
Hotel
ACCOMMODATIONS
Special Needs (please provide details)

CREDIT CARD : (Required to secure reservation. One night - $149++ - will be charged at time of booking)
Cancellation policy: 72 hours prior to arrival date.

Card Number *
Name on Card *
Check-in Date *
Expiration Date *
   
Check-out Date *

Attire: Business / Resort Casual

Not Staying at Bally's...?

If you will not be staying at Bally's, but will be attending the Jamboree, please complete the following:

Arrival Date *
Departure Date *
Guest Information

If you will be bringing a guest(s), please provide us with the following information:

Guest #1 Guest #2
Full Name *

Badge Name

(If attending any functions)

Full Name *

Badge Name

(If attending any functions)

Will your guest be attending any meeting sessions?


Will your guest be attending any of the meal  functions? (Check all that apply)

Wednesday, February 11
Thursday, February 12

Friday, February 13

Signature: Date:

Thank you for registering for the 2009 Jamboree.
We look forward to seeing you there.


Completed forms may also be faxed to
Carole Reisch at 661 295 4661

Taking your Practice From Success to Significance!

 

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Foresters Financial Partners · 28005 N. Smyth Dr. Suite 103, Valencia, CA, 91355 · 661-295-4660