NWR Convention & Banquet Registration Form

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Northwest Region

50+ Years in the PNW

Northwest Region

1405 NW Harrison Ave #203

Olympia, WA 98502

> Convention & Banquet Registration Form

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2010 NWR Convention & Anniversary Banquet

Registration Form

If you are attending the convention and a guest is coming to the banquet only (or banquet and party) please fill out a separate form with the required fields.

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* required fields

REGISTRANT INFORMATION:

First Name* Last Name*

Address City State Zip

Day Phone: Evening Phone

Email*:

Region of Record or Company Name Membership #

EVENT FEES:

Early Registration ends December 26th (prices increase $25 after that)

Please select menu preferences below for meals you are attending.

Full Weekend Registration (Includes all meals* & activities) $120.00 (Early Registration)

All Day Saturday (Training, Lunch*, & Banquet*) $110.00 (Early Registration)

Convention Only (Friday, Saturday Training, Lunch*, Sunday Meeting) $ 75.00 (Early Registration)

Saturday Training & Lunch* $ 70.00 (Early Registration)

Saturday Night Banquet* ONLY $ 45.00 (Early Registration)

Single Seminar $ 15.00 per session

Friday Night Social/Party: Yourself #Guests $ 10.00 Each

Sunday Meeting Only $ 10.00 Each

Please choose Lunch and Dinner choices IF attending

Lunch Selection *

Banquet Selection *

PAYMENT METHOD:

By Check: Amount $

By Credit Card: Type Amount $ Name on Card

Credit card information will be collected directly from you.

SPECIAL NEEDS

Indicate any dietary needs: Diabetic Vegetarian Other (please list)

Allergies Please indicate allergy

HOTEL RESERVATIONS AND INFORMATION

You are responsible for making your own hotel reservations and you must ask for the SCCA block to get the discounted rates. Group Code NWR-SCCA

HOTEL RESERVATIONS AND INFORMATION

BEST WESTERN RIVER’S EDGE, Tukwila, WA

15901 West Valley Hwy. Tukwila, WA 98188 800-544-9863

Rates good through December 24, 2009.

- $89.00 for single or double occupancy. Rates are available for Thursday through Sunday nights

- FREE Parking, FREE Shuttle 5 miles radius (Includes Sea-Tac Airport) 24/7

- Free Internet Access, Exercise Facilities, Steam room, sauna Restaurant on site, Lounge,

- Complimentary full breakfast Hot eggs, sausage, fresh waffles, fruit, yogurt, pastries, juices, cereals, coffee

- All rates are subject to state & local taxes, fees and assessments currently at 12.4%.

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