Download to register by fax or email

CONFERENCE REGISTRATION FORM
Office: 3450 NE 12th Terrace, Ft. Lauderdale, FL 33334
Phone: (954) 563-4444 Fax: (954) 563-1599 E-mail: [email protected]
www.WinterMusicConference.com
Were you a registered delegate at WMC 2015?
Yes
March 21-24, 2016
No
WMC Badge
$395 ................................... received by Mar. 11, 2016
WMC 2016 t-shirt
Remixing & Editing Workshop (1/2 day session):
$20.. .................
Introduction/101 ..............................................$75
Intermediate/Advanced ..................................$75
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Registration includes access to panels, seminars, featured Q & A's, WMC official poolside events, South Beach Sessions, trade show & exhibits, and workshops (with the exception of the Remixing and Editing
Workshops), DJ Spin-Off's, VJ Challenge as well as complimentary or reduced admission to WMC official and sanctioned events.
Please use one form per person. PLEASE PRINT. The name and company on your badge will appear exactly as they are on this form.
Full Name
Badge Name
name you would like to appear on badge if different from full name
Company
Job Title
Address
City
Province/State
Zip/Postal Code
Country
Email
Web
Country Code (
) Phone (
Fax (
)
)
Please Describe Your Business
Discover
Money Order
Check
Credit Card Billing Address
Card Number
Signature
Exp. Date
CID/CVV#
Visa / Master Card: last 3 digits
on signature strip
American Express: 4 digits
above card # on front
Cardholder’s Email Address
BADGES ARE NON-REFUNDABLE. NO REFUNDS OR CREDITS WILL BE GIVEN.
WAIVER
By registering for WMC 2016, I agree to the following: In the event of a stolen, lost or misplaced badge(s), replacement of same is the sole responsibility of the registrant.
WMC will not replace lost badges. There will be an additional fee of $495 for registrants to obtain a duplicate badge. Absolutely no refunds or credits will be given. I
acknowledge and agree that the Winter Music Conference (or any of its divisions, subdivisions, subsidiaries, affiliates, successors, or assigns, which shall in combination be
referred to as WMC) and its agents, servants, employees, officers, and directors shall have no liability for damage or injury to the persons or property of the registrant from
any cause whatsoever that may occur on convention premises or any sponsored event during the duration of WMC. Badges are non-transferable. I have read, understand
and agree to the above.
MAIL T O: 3450 NE 12th Terrace, Fort Lauderdale, FL 33334 or FAX TO: (954) 563-1599
F O R O F F IC E US E O NLY
Print Cardholder Name
Please make checks and money
orders payable to Winter Music
Conference, must be drawn on
US bank. No checks accepted
after February 26, 2016.
A .P.
Visa
Notes
Master Card
D .P.
AMEX
R c vd.
Method of Payment