| Mail-in Participant Registration
Please complete the form mail it to the address shown below.
Please use one registration for each individual attendee.
*First Name: ____________________________________________
*Last Name: ____________________________________________
Title:__________________________________________________ Organization___________________________________________
*Address Line #1: _______________________________________
*Address Line #2: _______________________________________
*City: __________________*State___________*Zip Code_____________
*E-mail: _________________________
*Contact Telephone: (______)_________________________
Contact Fax: (_____)________________________________
*In case of emergency contact:
Name: ________________________________________
Phone: (_____)_________________________________
Special Dietary Needs __Vegetarian __ Kosher Allergy: ______________
Please mail your completed form to:
EasyChair Media, 800 Third Street, Windsor, CO 80550.
Please read and check the box to acknowledge your understanding of our policies:
*______ Photographs and/or video tape will be taken during Bigger than Business…It’s your Life. By registering for this event you agree to allow Bigger than Business…It’s your Life to use photographs and/or video tape that may include shots or likenesses of you in any Bigger than Business…It’s your Life publications, marketing and promotional materials, or our web site. If such photos/video are used, you are not entitled to receive any remuneration, royalties or other such payment.
*______ Privacy Policy: Your name, address and e-mail will be published in the Bigger than Business…It’s your Life program which is distributed to all attendees and Sponsors. Before and after the event, you will receive information from the Bigger than Business…It’s your Life planning committee and sponsors about ongoing events and promotions.
Questions? Please call Jodi Vader at 970.686.7186
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