JOIN US! REGISTRATION FORM Register by April 29 2015 NIR SA SPORT CLUB I N S T I T U T E NIRSA COLLEGIATE SPORT CLUB INSTITUTE June 10-12, 2015 Web: http://nirsa.net/nirsa/sportclub2015 About You Email:billing@nirsa.org Last Name Fax:541‑766-8284 Title Mail with payment: NIRSA Headquarters 4185 SW Research Way Corvallis, OR 97333-1067 Institution / Installation / Agency First Name as you would like it to appear on your badge Business Mailing Address City State / Province Day Phone Fax Number Zip Email £ It’s okay to share my email address with Associate Members/Nonmembers who are also attending this event ❑❑ Disability Services Requested. Orders submitted by fax or mail will take 2-3 business days to process and will be handled on a first-come, first-served basis. £ Visual £ Hearing £ Physical £ Accompanying Personal Care Assistant £ Other% For More Information If you choose any of the above options a NIRSA representative will contact you to follow up regarding your request. Registration Prices Early Bird Regular On/Before 04/29/2015 After 04/29/2015 Professional/Student Member from a Member Institution ❍❍$375 ❍❍$445 Additional Member from the same Member Institution ❍❍$350 ❍❍$420 Professional/Student Member from a Nonmember Institution ❍❍$425 ❍❍$495 Individual Nonmember from a Member Institution ❍❍$510 ❍❍$580 Individual Nonmember from a Nonmember Institution ❍❍$545 ❍❍$615 One Day (Professional/Student Members) m Wednesday m Thursday m Friday ❍❍$200 ❍❍$270 Associate Member w/ table top exhibit ❍❍$600 ❍❍$670 Associate Member attending only ❍❍$450 ❍❍$520 Associate Member exhibiting only ❍❍$300 ❍❍$370 Additional Associate Member ❍❍$200 ❍❍$270 Company Nonmember w/ table top exhibit ❍❍$850 ❍❍$920 Company Nonmember attending only ❍❍$600 ❍❍$670 Company Nonmember exhibiting only ❍❍$500 ❍❍$570 Additional Company Nonmember ❍❍$300 ❍❍$370 One Day (Associate Members) m Wednesday m Thursday m Friday ❍❍$250 ❍❍$320 SC_150515 Contact us: education@nirsa.org Policies & Information PAYMENTS Payment via check, money order, or credit card is acceptable. If paying by credit card, payment is due with the registration form. You may include a purchase order number on your registration form to indicate a forthcoming check; however, a purchase order is not considered payment and no purchase orders will be accepted after April 29, 2015. If you are paying by check or money order, your check or money order must be postmarked by April 29, 2015. Checks and money orders must be payable to “NIRSA,” and foreign checks must be imprinted “US Funds.” You will be mailed a confirmation/receipt within 5 days of receipt of your registration at the NIRSA Headquarters. If you do not receive an email, contact the NIRSA Headquarters at 541-766-8211. An email address is required to receive a receipt/ confirmation of registration. Preconference Events *This event has a maximum capacities. There may still be space available for preconference events; for more information please contact Brittany Rejda at brittany.rejda@nirsa.org Registration Closed on 05/13/2015 *Bike Tour of Minneapolis, 6/9/15 1:30pm-4:30pm Take advantage of this opportunity to bike around America’s Best Bike City! Lead by University of Minnesota staff, all bikes, helmets, locks, and emergency supplies will be provided. Attendees will depart from the Host Hotel. ❍❍$40 Height: Weight: *Night at the Ball Game: Twins vs. Royals, 6/9/15 6:00pm9:30pm Meet in the host hotel lobby for transportation to Target Field. Price includes ticket to the game and $10 for the concession stand. ❍❍$40 REFUND POLICY FOR ALL CANCELLATIONS Cancellation of registration for NIRSA educational events and refund requests must be made in writing (mail, fax, email) to: Cancellation, c/o Billing Coordinator, NIRSA, 4185 SW Research Way, Corvallis, OR 97333-1067; fax: 541-766-8284; email: billing@nirsa.org • Cancellations received on or before April 29, 2015 will receive a 100% refund. • Cancellations received between April 30, 2015 & May 27, 2015 will receive a 50% refund. • Refunds cannot be guaranteed for cancellations received after May 28, 2015 or for no-shows at the event. Extenuating circumstances may warrant exceptions to the Refund Policy. For a review of a specific refund amount, please contact the Billing Coordinator: billing@nirsa.org. NON-SMOKING POLICY Payment TOTAL Balance must be paid in full before registration can be processed. m Visa m MasterCard m Discover m American Express m PO/Check# __________ Credit Card # Expiration Date Signature m I would like to use a second card for a portion of the total. Total to be charged to this card: $ _______________ m Visa m MasterCard m Discover m American Express Credit Card # Expiration Date Signature For the comfort and health of attendees, smoking is not permitted at any NIRSA function. BEING RESPONSIBLE Recognizing that many will take advantage of the opportunity for socializing and alcohol consumption, the Sport Club Institute Committee actively encourages responsible decision-making and healthy choices. Supporting this policy, non-alcoholic beverages will be offered at all NIRSAsponsored receptions. In accordance with state law, no alcohol will be served to anyone under age 21. WHAT TO WEAR Suggested conference attire is business casual. PHOTOGRAPH & VIDEO CONTENT OWNERSHIP NIRSA will use photographs and video taken during the Instititue to promote the Association and future events. Your registration form provides NIRSA with the unrestricted right to use photographs and video at its discretion for the purpose outlined above. 2015 NIR SA SPORT CLUB I N S T I T U T E
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