Oct. 5 - Oct. 8, 2009 • Harrah's Casino & Hotel - Tunica, MS

ICE Conference 2009 Online Registration

Please fill this form out accurately and completely before submitting.

Attendee's Name

Attendee's Title


Company Name


Company Street Address


City


State

Zip


Phone#


Attendee's Email Address


Are you part of a 3 or more group eligible for additional $50 discount?
(To receive the 3 person discount ($50 off each registration), all 3 people must be registered at the same time and work for the same company. Should cancellations reduce the group below 3, each individual will be assessed the $50.)
Please Choose Yes or No Yes No

Shirt Size
Please Choose Size Small Medium Large XL XXL XXXL


Social Activities

Will you be playing in the Annual MC² Golf Tournament?
Please Choose Yes or No Yes No

If so, please indicate your approximate HCP (Handicap) or AVG score.

Will you be attending the Welcome Reception Monday Night?
Yes No

Will you be joining us for lunch Tuesday and Wednesday?
Yes No

Will you be attending the Wednesday Night Dinner?
Yes No


Spouse/Companion Information
($150 Fee - Spouse/Companion's travel, hotel, and other expenses are not included in the conference fee for attendees or the spouse/companion fee.)

Will your spouse/companion be attending with you?
No Yes

Spouse/Companion's Name (if attending)

Will your spouse/companion attend the Welcome Reception Monday Night?
No Yes

Will your spouse/companion be participating in the golf tournament ($50 Fee)?
No Yes

If so, please indicate his/her HCP (Handicap) or AVG score.

Will your spouse/companion be joining us for lunch on Tuesday and Wednesday?
No Yes

Will your spouse/companion be attending the Wednesday Night Dinner?
No Yes

Registration Fees and Payment Information

Registration Fee* - $1450 ($1250 Early Bird - Registration by July 15) $1245
Spouse/Companion - $150
Spouse Golf Outing - $50
3 or more Registration Discount** - $50

All rates are U.S. Dollars.

*Does not include travel, accomodations or other expenses

** To receive the 3 person discount ($50 off each registration), all 3 people must be registered at the same time and work for the same company. Should cancellations reduce the group below 3, each individual will be assessed the $50. No registration will be considered official without payment.

Space at this year's conference is limited. Please be as accurate as possible in all submitted information. Registering online will hold a reservation for 10 days. Your reservation will not be considered official until payment is received.

Payment can be made by mailing a check to:

MC²
ATTN: ICE Conference Registration
5100 Poplar Ave., Suite 3400
Memphis, TN 38137-3400

or

By calling Melony Duggin at 800.225.5622 with your Visa, Mastercard or American Express number.

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