Registration form IHRSA Convention & Tradeshow (28

BOOKING FORM FOR IHRSA CONVENTION NAME: IHRSA NO: CLUB/COMPANY: FIA NO:Registration Fees for IHRSA ConventionRegistration details Registered by 28 Registered Number of people Total Cost February after 28 attending February4-Day Registration• Non-Member $895 $995• IHRSA Member $695 $7953-Day Registration• Non-Member $850 $895• IHRSA Member $650 $6952-Day Registration• Non-Member $650 $725• IHRSA Member $450 $5251-Day Registration• Non-Member $475 $500• IHRSA Member $275 $3004-Day Executive Pass• Non-Member $650 $725• IHRSA Member $450 $525Social Pass• IHRSA Member Only $275 $300Trade Show Only $30 $50 Total payable to FIA: $Please provide names of any additional attendees: 1. ____________________________________________________________________ 2. ____________________________________________________________________ 3. ____________________________________________________________________Payment for all events should be made on completion of this form below.Please tick your chosen payment method: Credit/Debit Card Please enter your details below. Cheque Please make cheques payable to “Fitness Industry Association Ltd” and post asap to the address below along with this booking form.Card Type: □ Visa □ Electron □ MasterCard □ MaestroCard Number:Start Date: Expiry Date:Issue No: Verification Code ______ (last three digits on the back of the card)Name on card:Cardholders Signature:Address details (if you require a receipt): Fax/post/email your completed form using the details below. Your booking will be confirmed via email within 5 working days of receipt of your booking form and payment details. FIA, Castlewood House, 77-91 New Oxford Street, London, WC1A 1PX Tel: 020 7420 8564 Fax: 020 7420 8561 Email: jessica@fia.org.uk website: www.fia.org.uk

Registration form IHRSA Convention & Tradeshow (28

by Fitness Industry Association on Feb 16, 2012

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Registration form IHRSA Convention & Tradeshow (28 — Document Transcript