Florida RIMS Conference, Inc
2016 FLORIDA CHAPTERS ANNUAL EDUCATIONAL CONFERENCE
EARLY REGISTRATION INSTRUCTIONS
REGISTRATION & PAYMENT VIA CREDIT CARD: Please visit our website at http://www.floridarimsconference.com. Note: An $11.00 transaction fee will be added to each individual registration.
REGISTRATION & PAYMENT BY CASH, CHECK or MONEY ORDER: Please complete the 2016 CONFERENCE REGISTRATION FORM (attached) and send it to Mike Benishek at the address on the bottom of the form. You must enclose your payment. Forms sent without payment will NOT be processed. Registration and Hotel Room Forms are located at: http://florida.rims.org NOTE: PLEASE DO NOT send it “SIGNATURE REQUIRED”. No one is at home during the day to sign for it. It is 20 miles to the FedEx facility to pick it up…..
SPONSORS - FREE REGISTRATIONS: If your sponsorship “package” includes free registrations, simply fill out one registration form for each complimentary registration and send it to the address on the form, or email it to [email protected] . In the “TOTAL ENCLOSED” line please write “Free 1 of 10, or Free 3 of 4, etc.
HOTEL ROOM: FAX your HOTEL ROOM RESERVATION FORM (attached) to The Ritz-Carlton at the FAX number listed on the hotel form. You must FIRST be registered for the Conference, BEFORE you fax in your hotel room reservation request. Rooms will be held for the RIMS Conference until June 10, 2016, or until the room block is full. NOTE #1: If you fail to register for the 2016 Florida RIMS Educational Conference, the discounted hotel room rates will not apply. You will be charged the currently prevailing “street price” for the room by the Ritz-Carlton. NOTE #2: Access to Gulf View Suites and Club Level rooms are part of the Platinum Level and Gold Level Sponsorship Packages only. Sponsors that qualify must contact Mike Benishek to reserve these premium rooms at the discounted conference hotel room rate. Rooms will be held for the RIMS Conference until June 10, 2016, or until the room block is full. Contact Mike Benishek at [email protected] W-9 FORM: If your organization requires a “W-9” form, it is located on the last page of this document, and on our website http://florida.rims.org . Please give it to your Accounting Department. Florida RIMS Conference, Inc. Federal Tax ID# 65-0911025 If you have any registration questions, please contact Mike Benishek at: [email protected] If you register for the Florida RIMS Educational Conference, your contact information may be shared with conference sponsors. If you prefer to keep your information private, you can opt out by contacting [email protected] .
2016 FLORIDA RIMS ANNUAL EDUCATIONAL CONFERENCE
00
July 26 - July 30, 2016 “EARLY” REGISTRATION FORM
Save $250. by registering before the June 10, 2016 Deadline ** PLEASE COMPLETE ONE FORM FOR EACH PERSON ATTENDING THE CONFERENCE ** ** PAYMENT MUST BE INCLUDED OR YOUR REGISTRATION WILL NOT BE PROCESSED ** (Note: If you register & pay via credit card on our website you do not have to fill out this form)
NAME ____________________________________ __________________________________ (first)
(last)
TITLE _____________________________ Email___________________________________ COMPANY NAME ____________________________________________________________ STREET ADDRESS ___________________________________________________________ CITY _______________________________ STATE _____________ ZIP CODE ___________ PHONE _______________________________ FAX ________________________________ Spouse or Companion Name_________________________________________________________ (if attending)
(first)
(last)
#1 - RIMS MEMBERS – I certify that I am currently a (circle one answer) Primary Organizational Member Educational Member
Alternate Organizational Member
Student Member
Transitional Member
I belong to the _________________________________ RIMS Chapter.
Associate Member Retired Member Your “Early” Registration Fee is $175
#2 - NON-MEMBER RISK MANAGER or HUMAN RESOURCES MANAGER – “FIRST TIME ATTENDEE” If you are a Risk Manager or HR Manager (NO other job positions are eligible) for a firm that is not a member of RIMS, AND this is your very first time attending the Florida RIMS Conference, then Your “Early” Registration Fee is $175 #3 - NON-MEMBER RISK MANAGER or HR MANAGER – “REPEAT ATTENDEE” If you are a Risk Manager or HR Manager who previously attended the Florida RIMS Conference (at any time, or with any prior employer), and your current firm has decided not to join RIMS, then Your “Early” Registration fee is $475 #4 - CONFERENCE SPONSORS (requires a minimum contribution of $3,500) If your organization is a Sponsor of the Florida RIMS Educational Conference then
#5 - ALL OTHERS (i.e. - Sales, Attorneys, TPA’s, Transportation/Translation, Rehab, etc.)
The Florida RIMS Conference, Inc. Tax I.D. Number is: 65–0911025
Your “Early” Registration Fee is $200
Your “Early” Registration Fee is $475 TOTAL ENCLOSED $_________________
REFUND POLICY – There are NO REFUNDS (repeat….. NO REFUNDS) for cancellation of the Registration. PAYMENT: Cash, Check or Money Order via USPS mail. Purchase Orders are NOT accepted. Please mail your Conference Registration form, a Business Card, and your registration payment to: Florida RIMS Conference, Inc. 607 Ixora Avenue Ellenton, FL. 34222 Attn: Mike Benishek ****************************************************************************************************************************************************** Payment via Credit Card is available at this website only – http://www.floridarimsconference.com 00 (NOTE: An $11. Processing fee will be automatically added per each individual registrant) ***************************************************************************************************************************************************** For more information concerning conference event sponsorship, golf, hotels, educational sessions and social networking events, please visit our website: http://florida.rims.org REGISTRATION QUESTIONS ? Contact [email protected] If you register for the Florida RIMS Educational Conference, your contact information may be shared with conference sponsors. If you prefer to keep your information private, you can opt out by contacting [email protected] .
RISK AND INSURANCE MANAGEMENT SOCIETY 2016 FLORIDA RIMS ANNUAL EDUCATIONAL CONFERENCE TUESDAY, JULY 26 – JULY 30, 2016 There are a limited numbers of rooms at the group rate. All reservations must be received by Friday, June 10, 2016. After this time, reservations will be accepted on a space available basis at the prevailing hotel room rates plus taxes. *** Pet-friendly rooms are available at The Ritz-Carlton Golf Resort, Naples but require advance registration and a $150 non-refundable pet fee.
Please Print or type. ONLY ONE ROOM IS PERMITTED PER CONFERENCE REGISTRANT Name:______________________________________________________Company:______________________ (Last)
(First)
Address:____________________________________________________ City:__________________________ State: ____________________________ Zip:______________________ Phone:_________________________ Email: ___________________________________ Ritz-Carlton/Marriott Rewards # _______________________ Arrival Date_____________________________________ at___________ (am/pm) No. of Adults: ___________ (Check-in time is after 4 pm)
Departure Date___________________________________ at___________ (am/pm) No. of Children: ___________ (Check-out time is before 11 am) * The maximum number of people per guest room is four (4) in double bedded rooms, and (3) in a king bedded room. ** Rollaway beds are not available. Small cribs are available at no extra charge. *** Pet-friendly rooms are available at The Ritz-Carlton Golf Resort, Naples but require advance registration and a $150 non-refundable pet fee.
ROOM REQUEST:
The Ritz-Carlton, Naples (Beach Resort)
Coastal View Room (*Run of House): $185 per night (plus tax) Gulf View Room King Bed - $225 per night (plus tax) Gulf View Room Double Beds - $250 per night (plus tax)
Gulf Front Room King Bed - $265 per night (plus tax) Gulf Front Room Double Beds - $290 per night (plus tax)
The Ritz-Carlton Golf Resort, Naples (Golf Resort)
Golf Course View - King Bed - $224 per night (plus tax) Resort View Room (*Run of House) - $174 per night (plus tax) Golf Course View - Double Beds - $249 per night (plus tax) Executive Suite - $269 per night (plus tax) *Bed type is on request only and not guaranteed for Coastal Room Run of House and Resort Room Run of House
METHOD OF PAYMENT:
CREDIT CARD OR ADVANCE DEPOSIT IS REQUIRED TO CONFIRM ROOM RESERVATIONS American Express Master Card Visa Discover Credit Card Number (required) ___________________________________Expiration Date_________________
(Must be after July 2016) Special Requests: _________________________________________________________________________________________ (Note: The Ritz-Carlton Resorts of Naples are ‘Smoke-free’ facilities.)
Signature (required) ____________________________________________________ Date______________________________
***Platinum and Gold Level Conference Sponsors that qualify for Gulf View Suites or Club Level rooms must contact Mike Benishek at [email protected] to reserve them***
** PLEASE FAX YOUR RESERVATION TO (239) 598 – 6631** THE RITZ-CARLTON, NAPLES | 280 VANDERBILT BEACH ROAD |NAPLES |FLORIDA 34108 TELEPHONE: (239) 598-3300 – FACSIMILE: (239) 598-6631 ***RESERVATIONS ARE NOT CONFIRMED UNTIL YOU RECEIVE AN EMAIL CONFIRMATION*** CANCELLATION POLICY Cancellations are permitted up to 7 days to arrival. If a reservation is cancelled within 7 days of arrival, a two night cancellation penalty will be charged to the credit card number provided. Rooms will be held for FL RIMS Conference until Friday, June 10, 2016, or until the room block is full. Early departures could result in additional penalties.
EARLY REGISTRATION INSTRUCTIONS
REGISTRATION & PAYMENT VIA CREDIT CARD: Please visit our website at http://www.floridarimsconference.com. Note: An $11.00 transaction fee will be added to each individual registration.
REGISTRATION & PAYMENT BY CASH, CHECK or MONEY ORDER: Please complete the 2016 CONFERENCE REGISTRATION FORM (attached) and send it to Mike Benishek at the address on the bottom of the form. You must enclose your payment. Forms sent without payment will NOT be processed. Registration and Hotel Room Forms are located at: http://florida.rims.org NOTE: PLEASE DO NOT send it “SIGNATURE REQUIRED”. No one is at home during the day to sign for it. It is 20 miles to the FedEx facility to pick it up…..
SPONSORS - FREE REGISTRATIONS: If your sponsorship “package” includes free registrations, simply fill out one registration form for each complimentary registration and send it to the address on the form, or email it to [email protected] . In the “TOTAL ENCLOSED” line please write “Free 1 of 10, or Free 3 of 4, etc.
HOTEL ROOM: FAX your HOTEL ROOM RESERVATION FORM (attached) to The Ritz-Carlton at the FAX number listed on the hotel form. You must FIRST be registered for the Conference, BEFORE you fax in your hotel room reservation request. Rooms will be held for the RIMS Conference until June 10, 2016, or until the room block is full. NOTE #1: If you fail to register for the 2016 Florida RIMS Educational Conference, the discounted hotel room rates will not apply. You will be charged the currently prevailing “street price” for the room by the Ritz-Carlton. NOTE #2: Access to Gulf View Suites and Club Level rooms are part of the Platinum Level and Gold Level Sponsorship Packages only. Sponsors that qualify must contact Mike Benishek to reserve these premium rooms at the discounted conference hotel room rate. Rooms will be held for the RIMS Conference until June 10, 2016, or until the room block is full. Contact Mike Benishek at [email protected] W-9 FORM: If your organization requires a “W-9” form, it is located on the last page of this document, and on our website http://florida.rims.org . Please give it to your Accounting Department. Florida RIMS Conference, Inc. Federal Tax ID# 65-0911025 If you have any registration questions, please contact Mike Benishek at: [email protected] If you register for the Florida RIMS Educational Conference, your contact information may be shared with conference sponsors. If you prefer to keep your information private, you can opt out by contacting [email protected] .
2016 FLORIDA RIMS ANNUAL EDUCATIONAL CONFERENCE
00
July 26 - July 30, 2016 “EARLY” REGISTRATION FORM
Save $250. by registering before the June 10, 2016 Deadline ** PLEASE COMPLETE ONE FORM FOR EACH PERSON ATTENDING THE CONFERENCE ** ** PAYMENT MUST BE INCLUDED OR YOUR REGISTRATION WILL NOT BE PROCESSED ** (Note: If you register & pay via credit card on our website you do not have to fill out this form)
NAME ____________________________________ __________________________________ (first)
(last)
TITLE _____________________________ Email___________________________________ COMPANY NAME ____________________________________________________________ STREET ADDRESS ___________________________________________________________ CITY _______________________________ STATE _____________ ZIP CODE ___________ PHONE _______________________________ FAX ________________________________ Spouse or Companion Name_________________________________________________________ (if attending)
(first)
(last)
#1 - RIMS MEMBERS – I certify that I am currently a (circle one answer) Primary Organizational Member Educational Member
Alternate Organizational Member
Student Member
Transitional Member
I belong to the _________________________________ RIMS Chapter.
Associate Member Retired Member Your “Early” Registration Fee is $175
#2 - NON-MEMBER RISK MANAGER or HUMAN RESOURCES MANAGER – “FIRST TIME ATTENDEE” If you are a Risk Manager or HR Manager (NO other job positions are eligible) for a firm that is not a member of RIMS, AND this is your very first time attending the Florida RIMS Conference, then Your “Early” Registration Fee is $175 #3 - NON-MEMBER RISK MANAGER or HR MANAGER – “REPEAT ATTENDEE” If you are a Risk Manager or HR Manager who previously attended the Florida RIMS Conference (at any time, or with any prior employer), and your current firm has decided not to join RIMS, then Your “Early” Registration fee is $475 #4 - CONFERENCE SPONSORS (requires a minimum contribution of $3,500) If your organization is a Sponsor of the Florida RIMS Educational Conference then
#5 - ALL OTHERS (i.e. - Sales, Attorneys, TPA’s, Transportation/Translation, Rehab, etc.)
The Florida RIMS Conference, Inc. Tax I.D. Number is: 65–0911025
Your “Early” Registration Fee is $200
Your “Early” Registration Fee is $475 TOTAL ENCLOSED $_________________
REFUND POLICY – There are NO REFUNDS (repeat….. NO REFUNDS) for cancellation of the Registration. PAYMENT: Cash, Check or Money Order via USPS mail. Purchase Orders are NOT accepted. Please mail your Conference Registration form, a Business Card, and your registration payment to: Florida RIMS Conference, Inc. 607 Ixora Avenue Ellenton, FL. 34222 Attn: Mike Benishek ****************************************************************************************************************************************************** Payment via Credit Card is available at this website only – http://www.floridarimsconference.com 00 (NOTE: An $11. Processing fee will be automatically added per each individual registrant) ***************************************************************************************************************************************************** For more information concerning conference event sponsorship, golf, hotels, educational sessions and social networking events, please visit our website: http://florida.rims.org REGISTRATION QUESTIONS ? Contact [email protected] If you register for the Florida RIMS Educational Conference, your contact information may be shared with conference sponsors. If you prefer to keep your information private, you can opt out by contacting [email protected] .
RISK AND INSURANCE MANAGEMENT SOCIETY 2016 FLORIDA RIMS ANNUAL EDUCATIONAL CONFERENCE TUESDAY, JULY 26 – JULY 30, 2016 There are a limited numbers of rooms at the group rate. All reservations must be received by Friday, June 10, 2016. After this time, reservations will be accepted on a space available basis at the prevailing hotel room rates plus taxes. *** Pet-friendly rooms are available at The Ritz-Carlton Golf Resort, Naples but require advance registration and a $150 non-refundable pet fee.
Please Print or type. ONLY ONE ROOM IS PERMITTED PER CONFERENCE REGISTRANT Name:______________________________________________________Company:______________________ (Last)
(First)
Address:____________________________________________________ City:__________________________ State: ____________________________ Zip:______________________ Phone:_________________________ Email: ___________________________________ Ritz-Carlton/Marriott Rewards # _______________________ Arrival Date_____________________________________ at___________ (am/pm) No. of Adults: ___________ (Check-in time is after 4 pm)
Departure Date___________________________________ at___________ (am/pm) No. of Children: ___________ (Check-out time is before 11 am) * The maximum number of people per guest room is four (4) in double bedded rooms, and (3) in a king bedded room. ** Rollaway beds are not available. Small cribs are available at no extra charge. *** Pet-friendly rooms are available at The Ritz-Carlton Golf Resort, Naples but require advance registration and a $150 non-refundable pet fee.
ROOM REQUEST:
The Ritz-Carlton, Naples (Beach Resort)
Coastal View Room (*Run of House): $185 per night (plus tax) Gulf View Room King Bed - $225 per night (plus tax) Gulf View Room Double Beds - $250 per night (plus tax)
Gulf Front Room King Bed - $265 per night (plus tax) Gulf Front Room Double Beds - $290 per night (plus tax)
The Ritz-Carlton Golf Resort, Naples (Golf Resort)
Golf Course View - King Bed - $224 per night (plus tax) Resort View Room (*Run of House) - $174 per night (plus tax) Golf Course View - Double Beds - $249 per night (plus tax) Executive Suite - $269 per night (plus tax) *Bed type is on request only and not guaranteed for Coastal Room Run of House and Resort Room Run of House
METHOD OF PAYMENT:
CREDIT CARD OR ADVANCE DEPOSIT IS REQUIRED TO CONFIRM ROOM RESERVATIONS American Express Master Card Visa Discover Credit Card Number (required) ___________________________________Expiration Date_________________
(Must be after July 2016) Special Requests: _________________________________________________________________________________________ (Note: The Ritz-Carlton Resorts of Naples are ‘Smoke-free’ facilities.)
Signature (required) ____________________________________________________ Date______________________________
***Platinum and Gold Level Conference Sponsors that qualify for Gulf View Suites or Club Level rooms must contact Mike Benishek at [email protected] to reserve them***
** PLEASE FAX YOUR RESERVATION TO (239) 598 – 6631** THE RITZ-CARLTON, NAPLES | 280 VANDERBILT BEACH ROAD |NAPLES |FLORIDA 34108 TELEPHONE: (239) 598-3300 – FACSIMILE: (239) 598-6631 ***RESERVATIONS ARE NOT CONFIRMED UNTIL YOU RECEIVE AN EMAIL CONFIRMATION*** CANCELLATION POLICY Cancellations are permitted up to 7 days to arrival. If a reservation is cancelled within 7 days of arrival, a two night cancellation penalty will be charged to the credit card number provided. Rooms will be held for FL RIMS Conference until Friday, June 10, 2016, or until the room block is full. Early departures could result in additional penalties.
