1. Chesapeake Bay Division of the IAI
Spring 2017 Conference Attendance Form
Federal Tax EIN 52-2081374
Name for Certificate(s) Nickname for Badge
Dept/Agency/School E-mail
Address (H) (W) Phone Number
Family/Guest(s) Name(s) 1. 2. 3.
Full Participation: Breakfast and Dinner for each day included in full registration, to include a Saturday Banquet*.
CBD Member @ $175.00
Non-Member @ $200.00
Student @ $125.00** **Will you be attending the student lunch Friday
Family/Guest @ $160.00
Late Registration @ $225.00
(Registrations post-marked April 1st
, 2017 or after are considered late)
Daily Adult Registration (with meals): Friday $90.00 Saturday $90.00
Daily Adult Registration (no meals): Friday $60.00 Saturday $60.00
Saturday Banquet ONLY: $50.00 *Choose One Banquet Meal option
Grilled Marinated Salmon Herb Grilled Chicken Breast & London Broil Vegetarian
Additional Banquet Meals (For Guests/Non-Members)
Grilled Marinated Salmon (# If multi) Herb Grilled Chicken Breast & London Broil (# If multi) Vegetarian (# If multi)
Children (4-12 years of age) Meal Registration: Number of Children attending
Friday (Breakfast and Dinner) $40.00 Saturday (Breakfast and Banquet) $40.00 Child Banquet $25.00
Total Due $
Please see additional information and sign up for workshops on the second page.
Payment Information
Check Enclosed (make payable to CBD-IAI) Charge to Credit Card
Credit Card Number Expiration Date Security Code
Name as it Appears on Card Signature ___________________________________
Billing Address
Send Registration Form with Payment or Payment Information to:

2. Jessica Landi CBD Secretary-Treasurer P.O. Box 38369 Henrico, VA 23231 cbdiaisec@gmail.com
Conference Information
Location and Accommodations Full Registration Includes:
Holiday Inn Frederick Breakfast Friday
5400 Holiday Drive Buffet Dinner Friday
Frederick, Maryland Breakfast Saturday
Phone: 301-694-7500 Banquet Dinner Saturday
$98+ tax per night for single or double *If you would like a vegetarian/vegan option or have any other dietary
Hotel website: Holiday Inn Frederick restriction please let Jessica Landi know as soon as possible.
**PLEASE MAKE RESERVATIONS BY APRIL 1, 2017 TO RECEIVE DISCOUNT**
You must mention that you are with the “CBD” to receive the reduced rate! (Code: 99801505)
Please notify the Secretary-Treasurer if you have food restrictions, need a vegetarian meal or a child’s meal.
Persons that are not members or students or employed by or retired from government agencies or contractors need to have approval by a CBD-IAI
member to attend this conference. Member approving attendance __________________________
Conference name badges are required for admittance to all conference functions.
Visit the CBD-IAI online at www.cbdiai.org for additional information about the conference and the Division.
The Chesapeake Bay Division of the International Association for Identification, hereinafter known as the “Sponsor,” asserts the following disclaimer:
All persons, members and non-members of the Sponsor, participating in a scheduled training event of the Sponsor hereby agree by their participation to hold harmless the Sponsor
from any and all actions by the presenters of such training and results of whatsoever nature and cause which is not within the scope and purview of the training. This includes, but
is not limited to chemicals, powders, equipment failures, and faulty displays of whatsoever kind of nature. Any actions taken will be inclusive of indemnification of the Sponsor
against such third-party mishap, defect, either patent or cover, and the Sponsor will have no responsibility, express or implied, as determined by the laws of the State of Maryland,
the Corporate State.
Notice must be given to President Rebecca Wood of any such mishap within three (3) days of the event.
For speaker agenda please check the CBD-IAI website.