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Check:
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Consultant
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Company Name:
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Address:
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State:
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City:
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Zip:
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Consultant Type:
(Description)
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Consultant Name:
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Consultant Phone:
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Consultant email:
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Total Due:
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Check here if you will be mailing a check for payment. Address is to left.
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Check here if you will be making a credit card. Payment link is on Home page.
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Check here if new attendee
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List name of person that referred you to the conference.
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Note: The conference cannot guarantee the number of attendees at any time.
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Photo Release
I hereby give the Utility Payment Conference and its delegated representatives the
permission to photograph me alone and/or with other attendees in conjunction with and
for the conference. I/We understand the pictures may be used for the promotion of the
conference. Publications of photographs shall include, but is not limited to, the
conference website, future conferences, promotional brochures and flyers and other
forms of media.
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Liability Release Waiver Information
My registration indicates I agree to release the Utility Payment Conference and hotel
and each of their respective officers, directors, agents, representatives, and employees
and hotel (referred to collectively as "Releasees") from any and all claims, actions,
damages and liabilities, injury or loss that in any way are caused by, arise out of or
result from my participation in the Utility Payment Conference. My submitted
Registration form indicates I have read the Liability, Waiver and Release Information as
it applies to me.
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Cancellation and Change Policy
My submitted registration form indicates I have read, understand and agree to the
conference Cancellation and Change Policy and accept its' terms.
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Hotel Reservation Release
I hereby give the Utility Payment Conference and its delegated representatives
permission to inquire of the hotel information regarding my booked reservation. In
addition, the conference hotel(s) has my/our permission to disclose my/our reservation
information to the conference's delegated representation.
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Code of Conduct Policy
My/Our submitted registration form indicates I/We have read, understand and agree to
the conference Code of Conduct Policy and accept its' terms.
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