Pub. 4 2014 Issue 1

21 2014 IADA - CATA DEALER CONFERENCE REGISTRATION FORM *Note: All registration fees include resort charges for Bellman, Pool/Beach Attendant/Lifeguard and Maid gratuity fees per person per night. Children 12/over fees include above referenced fees and a $50 per night mandatory hotel charge. Maximum 4 people to a room. Passports Required: All travelers to and from the Bahamas must have a Valid US Passport. For those not born in the US, a visa may be required. For more information please visit www.travel.state.gov. PAYMENT SCHEDULE PERSONAL INFORMATION FLIGHT INFORMATION Please send your completed registration form to IADA, P.O. Box 3045, Springfield, IL 62708 or fax to 217-753-3424. If you have questions, please call Ann at 217-753-0220. Hotel room cut off is February 28, 2014. Cancellation must be received by February 28, 2014, in order to receive refund for room charges and cancellation costs. Registration information is also available online at www.illinoisdealers.com. I want to pay in full. (check enclosed) Please invoice me full amount this year. I want to pay 3 monthly installments: Oct/Nov/Jan Final payment due by January 24, 2014 Total: $____________ ÷ 3= $___________ I want to pay in full by AE/MC/Visa. Card Holder Name: __________________________________________________ Credit Card #________________________________________________________________Exp.__________________ Signature:________________________________________________________________________________________ Conference Registration & Lodging Fees Qty. Fee Total Dealer or Participating Sponsor Registration Fees/Lodging/Conference Package ( single ) $2,063.00 Non Participating Sponsor Registration/Lodging/Conference Functions ( single ) $2,563.00 Spouse/Guest Registration/Lodging/Conference Functions ( double occupancy ) $615.00 Room Request: ___ Double; ___ King; ___ Smoking; ___ Non-smoking Child Registration Fee (Age 11 & Under in room with parents) $300.00 *Teen Registration Fee (Ages 12 – 17 in room with parents) $632.00 *Young Adult Registration Fee (18+ in room with parents) $732.00 TOTAL AMOUNT DUE Arrival Date: Airline: Arrival Time: Departure Date: Airline: Departure Time: Name: Spouse/Guest: Child: Child: Dealership/Company: Address: City: State: Zip: Phone: Email: March 30 th - April 3 rd Atlantis Resort Paradise Island, Bahamas