ICMA XIV REGISTRATION FORM Back to Registration Information  f
I. Delegate Information: III. Registration Fees
Number Price Total
          Early-Bird Registration Fees
Last Name First Name Middle Initial (Must be received before July 1, 2001)
                      Delegate Rate _______ x $1,650 __________
                                Accompanying Person Rate _______ x    $550 __________
Name as you would like it to appear on your badge, if different from above. Registration Fees
                      Delegate Rate _______ x $1,800 __________
                                Accompanying Person Rate _______ x    $700 __________
Title Organization (To ensure availability, payment and registration form must be received before October 12, 2001
or register online at www.icmaxiv.org after October 12, 2001)
         
Mailing Address On-Site Registration Processing Fee _______ x    $150 __________
          SECTION III. Registration Subtotal ……………...……….. $ __________
City                              State/Province Zip/Postal Code Country
         
Phone Number Fax Number E-Mail Address Delegate and Accompanying Person Activities:
Please indicate your attendance at the following functions that are included
How many delegates are you registering?* ______________ in all registration fees and notify registrar or changes, when applicable.
Additional tickets may be purchased on-site (based on availability).
Please indicate and explain in full detail any special needs you may
have, i.e. diet, adaptive room, etc. ________________________ Delegate:
         
October 22, 2001-Lunch
In case of emergency, please contact o  Yes    o  No    o  Not Sure
         
Name October 22,2001-Welcome Cocktail Reception
          o  Yes    o  No    o  Not Sure
Day Time Phone Evening Phone
October 23, 2001 - Lunch
Attorneys requiring CLE Certificates please check here    o o  Yes    o  No    o  Not Sure
II. Accompanying Person Information October 23, 2001 - Tuesday Cocktail Reception
Accompanying Person fee includes cocktail reception on October 22 & o  Yes    o  No    o  Not Sure
23 and the Black Tie Dinner Dance on October 25.  Daily tours and
activities are available for accompanying persons.  (See Section V). October 25, 2001 - Lunch
o  Yes    o  No    o  Not Sure
All information for accompanying persons will be mailed to the
address of the delegate registrant. October 25, 2001 - Closing Banquet and Dinner Dance
o  Yes    o  No    o  Not Sure
How many accompanying persons are you registering? * __________
Accompanying Person:
         
Last Name First Name Middle Initial Monday, October 22, 2001 - Welcome Cocktail Reception
o  Yes    o  No    o  Not Sure
         
Name as you would like it to appear on your badge, if different from above. Tuesday, October 23, 2001 - Tuesday Cocktail Reception
o  Yes    o  No    o  Not Sure
Please indicate and explain in full detail any special needs you may
have, I.e. diet, adaptive room, etc. ________________________ Thursday, October 25, 2001 - Closing Banquet and Dinner Dance
          o  Yes    o  No    o  Not Sure
In case of emergency, please contact
          Notes: Prices and scheduled tours, activities and entertainment options listed
Name in Sections V, VI and VII are based on participation, availability and suppliers.
          Therefore, all events, activities, shows and tours are subject to change
Day Time Phone Evening Phone and cancellation, in which case options or refunds will be granted.
* Only (1) delegate and (1) accompanying person may register per form.
For multiple accompanying persons, photocopy this form.
IV. Optional New York Tours, Shows and Activities VI. Pre- and Post-Congress Tours/Trips
Date/Time/Event Number Price Total Date/Time/Event Number Price Total
Saturday, October 20, 2001 October 14-21,2001
9:00 a.m. - 3:00 p.m. New England and Canada Follage Cruise
Viewpoint on NewYork City Tour   x $70 =    Per Person, Based On Double Occupancy   x $1,499 =  
9:00 p.m. - 1:00 a.m.  Per Person, Based On Single Occupancy   x $2,599 =  
The Beat Goes On   x $85 =   October 26-29, 2001
Washington, D.C. Tour
Sunday, October 21, 2001  Per Person, Based On Double Occupancy   x $700 =   
9:00 a.m. - 3:00 p.m.  Per Person, Based On Single Occupancy   x $1,025 =  
Statue of Liberty and Ellis Island   x $75 =   October 26-30, 2001
Bermuda Trip
Wednesday, October 24, 2001  (Special Outing for Delegates & Accompanying Persons)  Per Person, Based On Double Occupancy   x $1,224 =  
8:30 a.m. - 6:00 p.m.  Per Person, Based On Single Occupancy   x $1,899 =  
Hudson River Adventure   x $175 =   
Section VI: Pre- and Post-Congress Tours/Trips Subtotal….. $ _________
Friday, October 26, 2001
6:00 p.m. - 10:00 p.m. VII. Total Fees Due
Cabaret   x $125 =             
Subtotal Section III. Registration Fees……………………...……. $
Saturday, October 27, 2001    
10:00 a.m. - 2:00 p.m. Subtotal Sectin IV. Optinal New York Tours,  
The Artist's Lifestyle Shows and Activities Fees …………………………..…………… $
Greenwich Village/SoHo   x $38 =      
4:30 p.m. - 9:30 p.m. Subtotal Section V. Accompanying Person Tour Fees ………… $
Twilight Tour of New York   x $70 =      
Total Amount Due …………………………………… $
Broadway Shows Daily          
Full Monty: Specify day/date        
o Matinee _____ x $120 or  o Evening Tickets _____ x $125 = _______ VIII. Payment Information
Payment Method:
The Producers: Specify day/date                o Check (U.S.$)   o  Credit Card   o  Bank Transfer
o Matinee _____ x $120 or  o Evening Tickets _____ x $125 = _______ Note: If paying by check, please attach check payable to Society of Maritime Arbitrators, Inc.
in U.S. $, drawn on a U.S. Bank.  If paying by bank transfer, please attach a copy of the bank
Follies: Specify day/date         transfer confirmation and your bank should address its' remittance to the following address
o Matinee _____ x $120 or  o Evening Tickets _____ x $125 = _______ HSBC Bank U.S.A., Bowling Green Office, 26 Broadway, New York, NY 10004, ABA
routing 021001088.  For credit to: Society of Maritime Arbitrators, Inc., 14 Wall Street,
Bells are Ringing: Specify day/date       Suite 8A15, New York, NY 10005, a/c #705-01511-4.  Include ICMA XIV and name of delegate.
o Matinee _____ x $120 or  o Evening Tickets _____ x $125 = _______
If payment is by credit card, please fill out the requested information below:
Section IV: Optional NY Tours & Activities Subtotal….. $ _________ Credit Card Type    o Visa    o  Master Card   o  American Express
         
V.  Accompanying Person Tours Name As It Appears on Card
Date/Time/Event Number Price Total
Monday, October 22, 2001          
9:00 a.m. - 3:00 p.m. Card Number Expiration Date
New York City Tour   x $70 =  
Tuesday, October 23, 2001
9:30 a.m. - 2:30 p.m.          
United Nations Tour & Luncheon   x $90 =   Authorized Signature
Thursday, October 25, 2001
9:00 a.m. - 3:00 p.m. For Office Use Only:        
Harlem Tour   x $128 =    Date In  ____________________________________________  
Friday, October 26, 2001 Check No. _________________________________________  
8:30 a.m. - 12:30 p.m. Method of Payment    o  Check  o  Bank Transfer   o  Cash
Guggenheim Breakfast & Tour     x $70 =                                  o Visa     o  Master Card      o  American Express
Section V: Accompanying Person Tours Subtotal….. $ _________ Amount ___________________________________________________