Meeting Registration Winter 2019

Meeting Registration Form
TMHA Regulatory & Economic Meeting – December 4th & 5th, 2019
Jumer's Casino & Hotel - Rock Island, IL

Only ONE attendee may register per registration form.

Name:^*
Company:^*

E-mail:^*

(Meeting Registration confirmations will be sent via e-mail!)
Best Phone Number:^*

IF YOUR COMPANY IS NOT A MEMBER, PLEASE PROVIDE THE FOLLOWING INFORMATION:

Your Title:
Mailing Address:

City:
State:
Zip:

Other Information About You or Your Company:

IMPORTANT NOTE: There is a $99 Registration Fee for this TMHA Meeting / Event. The fee is all-inclusive of the Meeting, Wednesday evening Dinner, and Meals and Breaks provided during the meeting.
I plan to attend the Wednesday evening Dinner:
I plan to attend the Thursday Meeting:

Guest's Name:
Company:

Title:
Email Address:

Guest Will Attend:

Boat CruiseDinnerSafety & Security Meeting

Payment Via:
($99)

Submit and Pay by CheckSubmit and Pay with Credit Card
PLEASE NOTE: If you are paying with Credit Card you will be redirected to the payment page after form submission.