2016 WINTER MEETING REGISTRATION FORM DEFENSE LAWYERS. DEFENSE LEADERS.
February 28 - March 4, 2016 | Hotel Del Coronado, San Diego, California
REGISTRATION TYPE (PLEASE CHECK) DEFENSE COUNSEL MEMBER q
CORPORATE OR INDUSTRY MEMBER q
NON-MEMBER GUEST q
Is this the FIRST meeting as a member? Yes q SECOND meeting as a member? Yes q
Last Name: __________________________________________ First Name: __________________________________________ MI: ____________ Firm Name: ________________________________________________ Name on Badge: ________________________________________________ Address: _______________________________________ City: _____________________________ State: __________ Zip: __________________ Country: ___________________________________ Phone:_____________________________ Email: ____________________________________ Home Address: ____________________________________________________________________________________________________________ Cell Phone: _______________________ State Bar/CLE No:______________________ ; ____________________ ; _________________________ Arrival Date: _____________________ Departure Date: _______________________ Hotel: The Del q Other _______________________________ Special Needs (Dietary restrictions, allergies, etc.): ________________________________________________________________________________
REGISTRATION FEES Registration Type
Registration Fee
Total
Defense Counsel Member or Non-Member Guest ........................ $1295 ..................................................... $ _____________________ Corporate/Industry Member............................................................. $695 ..................................................... $ _____________________ Spouse/Companion of Member ....................................................... $595 ..................................................... $ _____________________ 21+ years ......................................................................................... $595 ..................................................... $ _____________________ 18-20 ............................................................................................... $495 ..................................................... $ _____________________ 12-17 ............................................................................................... $425 ..................................................... $ _____________________ 5-11 ................................................................................................. $255 ..................................................... $ _____________________ Under 4 ........................................................................................... comp ..................................................... $ _____________________ *Charm: .......................................................................... __________ @ $150 ..................................................
$ _____________________
*To keep registration costs from increasing, charms are no longer included in the registration fee and must be pre-ordered.
_________________________________________________________________ *Email: ________________________________________________ Registered Spouse/Companion (First, Last & Badge Name)
*(spouse email for conference correspondence)
_________________________________________________________________________________________________________________________ Child’s First (Badge Name) and Last Age _________________________________________________________________________________________________________________________ Child’s First (Badge Name) and Last Age _________________________________________________________________________________________________________________________ Child’s First (Badge Name) and Last Age