NSMM Client Registration Form Company Name : Participation Fees Sponsorsip Level: Active ParticipationProduct Placement The Active Participation Fee is $5200 if your registration is completed by midnight (12:00 am EST) on January 25th, 2019. The Product Placement Fee is $1500. Additional Attendee: x$400 = Power needed to Booth: YESNOx ($85) = Total Participation Fees to be deducted: Accomodation Information Negotiated room rate of $260 per night for a standard room + taxes (payment due at checkout). Please note that accommodation costs are not funded by Tree of Life, however we do have to book the room for you if you are planning on staying at the Westin Harbor Castle (we strongly recommend you stay on-site). To book a room, please indicate arrival/departure information below. Authorization I: hereby authorize this form. Date: Attendee No. 1 Full Name(s): Email: Room Required: YESNO Arrival: Departure: Event Participation New Tree of Life Head Office & Warehouse Tour (Mon. Afternoon): YESNO Welcome Reception (Tue. Evening): YESNO Gala Dinner (Wed. Evening): YESNO Wrap Up Event (Thu. Evening): YESNO Dietary Restrictions: YESNO If yes: It's an AllergyJust a Preference Attendee No. 2 Full Name(s): Email: Room Required: YESNO Arrival: Departure: Event Participation New Tree of Life Head Office & Warehouse Tour (Mon. Afternoon): YESNO Welcome Reception (Tue. Evening): YESNO Gala Dinner (Wed. Evening): YESNO Wrap Up Event (Thu. Evening): YESNO Dietary Restrictions: YESNO If yes: It's an AllergyJust a Preference Attendee No. 3 Full Name(s): Email: Room Required: YESNO Arrival: Departure: Event Participation New Tree of Life Head Office & Warehouse Tour (Mon. Afternoon): YESNO Welcome Reception (Tue. Evening): YESNO Gala Dinner (Wed. Evening): YESNO Wrap Up Event (Thu. Evening): YESNO Dietary Restrictions: YESNO If yes: It's an AllergyJust a Preference Δ