MEDIA Online Registration September 10, 11 & 12, 2008
Quito, Ecuador
All online registrations are subject to final review and confirmation by William H. Coleman, Inc.
Company Information Please this registration form as you want the information to appear on your Media credentials.
Company/Publication Name:
Delegate Name:
Job Title:
Mailing Address:
City/State:
Country/Postal Code:
Telephone:
Please include the country code and city code, and/or area code, where applicable.
Fax:
Email:
Website:
Please provide general information about your company. (Limited to about 45 words):
Registration Fees
Your registration fee includes: One Delegate; additional delegate is $225.00; a Table-Top during the Marketplace on September 11 and 12, chairs, sign, Official Directory of Services, Meeting Guide/Appointment Book; Transfers on official arrival and departure days; and attendance at official social functions. Special airfares are offered by participating airlines serving Panama. Airline reservations and ticketing information is provided to all registered and confirmed delegates.
1 Media Table-Top @ $2,000 USD. Includes: One delegate, one Table-Top, up to four chairs, and a sign.
Number of Additional Delegates to register @ $225 USD per delegate.
Please Select 1 2 3
Additional Delegate First/Last Name/Job Title
Choose Payment Method:
Company Check (must be sent by courier)
Money Order (must be sent by courier)
Wire Transfer (Add US$10.00 processing fee)
Credit Card
Confirmation Letter Method: SELECT Fax Email
Terms of Agreement
Please read the TERMS OF AGREEMENT and check-off. Form will not be submitted unless the box marked "Yes" is checked:
All registrants are subject to the following terms and conditions. (1) All participation by any registrant must be approved by both Coleman, Inc. and the Sponsor. Acceptance of registration by Coleman, Inc. is contingent upon subsequent acceptance by the Sponsor. (2) Participants who register for the Program shall be entitled to cancel their registration in writing prior to the ninetieth (90th day) preceding commencement of the Program, subject to a cancellation fee of 50% of fees received. Thereafter, all registrants shall be deemed non-cancelable and all registration fees paid or owing shall be deemed non-refundable or non-cancelable. (3) All social events hosted by any registrants during the Program and any pre and post Program fam trips sponsored by any registrant must be approved by Coleman, Inc. and the Sponsor. (4) Coleman, Inc. and the Sponsor reserve the right to cancel any registrant without cause, at their discretion, at any time prior to the fifteenth (15th day) preceding commencement of the Program, conditioned upon full refund of such registrant's registration fee. (5) In the event of cancellation of the Program or any part thereof, because of a civil strike, civil discord, military action, natural event, or "act of God" occurring without fault on the part of Coleman, Inc. and/or Sponsor, there shall be no refund of fees paid or forgiveness of fees owed. (6) Coleman, Inc. and the Sponsor shall not under any circumstances be liable for more than the refund of a registrant's fees upon cancellation of any registrant's participation or upon cancellation, in whole or part, of any program for any reason. Coleman, Inc. and the Sponsor shall have no liability for consequential loss or damage of any kind arising out of any cancellation and their total and maximum liability shall be limited to refund of registration fees. (7) Limitation of Liability: In consideration for accepting and processing this registration application and permitting registrant to attend the subject meeting, registrant hereby agrees to release and hold Coleman, Inc. and the Sponsor, its officers and employees, harmless for any personal injury, loss, or harm occurring during and while traveling to or from the subject meeting, caused by third parties.
I agree with the terms above
Name:
Date:
Form Submission
TravelMart LatinAmerica 2008. After submission, you will be given the payment options and about 48 hours later, an Email or fax response will be sent to you.
Please note that all registrations are not confirmed until all fees have been paid and qualifications have been verified. If you are interested in any sponsorship opportunities, please contact us at sales@whcoleman.com