EmailMeForm
17th Annual Workers' Compensation Insurance ExecuSummit
January 28 & 29, 2020
Mohegan Sun Hotel & Convention Center, Uncasville, CT
www.WorkersCompConference.com
Welcome! Register online with our Secure 256-bit SSL Encryption. If you have any questions please feel free to contact us at 800-905-9357 x 705
The Earlier Your Register the More You Save:
Please Register Me for the 17th Annual Workers' Compensation Insurance ExecuSummit, January 28 & 29, 2020, Mohegan Sun Hotel & Convention Center, Uncasville, CT
Early-Bird Promotion: Register through December 30, 2019 .............................. $ 849.00
You Save $146 of Regular Registration.
Register December 31, 2019 through conference: Regular Registration ............................$ 995.00
Regular Registration Rate
Attendee Information:
First Name:
*
Last Name:
*
Title/Position:
*
Company Name:
*
Office Address:
*
Office Address Line 2:
City:
*
State / Province /Region:
*
Postal / ZIP Code:
*
Country / Region:
*
Phone:
*
###
-
###
-
####
Phone Extension:
Email:
*
CC this e-mail on Confirmation:
Enter a different e-mail here if you would like to be cc'd on e-confirmation
Select Method of Payment:
Card Type:
*
Please select
Visa
Master Card
American Express
Discover
Diners Club
Card Number:
*
Expiration Date:
*
Name as Appears on Card:
*
Card Billing Address:
*
Card Billing Address Line 2:
City:
*
State / Province /Region:
*
Postal / ZIP Code:
*
Country / Region:
*
EVENT VENUE - LOCATION INFORMATION:
Mohegan Sun
1 Mohegan Sun Blvd
Uncasville, CT 06382
ExecuSummit Preferred Rate: $149.00 per night, plus taxes & fees.
Your confirmation will provide our preferred rate code and phone number as well as a link to book your room online. Please do not book your room until you receive the e-confirmation email.
Group Rates Available
SAVE!!! Special Promotional Pricing for groups of 4 or more.
Register 3 delegates and Receive a 4th registration for the same event at no charge
Registration for this ExecuSummit includes presentation documentation provided by speakers, Post Summit-Materials, breakfast, Networking luncheon & refreshment breaks & cocktail reception.
Dress Attire: Business Casual.
Should you be unable to attend, a prompt refund less an administrative fee of $150 will be made for cancellations received in writing by December 30, 2019. There will be no refunds due to cancellations received after December 30, 2019. Non-Payment does not constitute a cancellation. You may transfer your registration anytime without admin fee. In the unlikely event this program is cancelled, ExecuSummit is not responsible for any airfare, hotel or other costs incurred by registrants. Every effort is made to ensure the speakers in our agenda appear, but speakers, agenda & other events are subject to change without notice.
*
By checking this box I have reviewed, agree to all terms and conditions above and authorize you to charge the credit card info above for the registration fee.
This box must be checked for your registration to be processed.
Please fill in the field below and click the submit button.
A confirmation will be e-mailed back to you shortly.
Please only hit submit once to avoid duplicate registrations.
Thank you for registering!