Name
September 23-25, 2021 Idaho Falls, Idaho
Name for Badge Title Address City, State Zip Phone Email Spouse/Guest Name Name for Badge
Fees Per Person Conference Registration (includes meetings, opening reception, breakfasts, and Friday night dinner) Spouse/Guest registration Fee (includes opening reception, breakfasts, and Friday night dinner)
Total
$425
$
$125
$
Total $ ___________
Return this form and payment to: Jackrabbit Bar Conference c/o Idaho State Bar PO Box 895 Boise, ID 8701 Or Email: sbeckwith@isb.idaho.gov Or FAX: 208-334-4515
Hotel Information: Hilton Garden Inn 700 Lindsay Blvd Idaho Falls, ID 83402 1-208-522-9500 Rate $149/night Block cutoff date 9/9/21 Cancellations must be confirmed with the hotel 24 hours prior to arrival to avoid a late cancellation fee.
For further information, contact Diane Minnich at (208) 334-4500 or dminnich@isb.idaho.gov Method of Payment: ___ Check Enclosed
Credit Card: ___ VISA ___ MasterCard
CC # _______________________________________________
Zip Code ________________
Signature ____________________________________________
23
CCV# _________ Exp. Date ______________
