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Western Roofing Expo 2012 Registration & Housing Form
 
E-Mail Address
 
Important: Enter a valid E-mail address. Receipts will be sent to this address.
E-Mail:*

Enter Valid E-Mail
Registrant Information
Registrant 1 - First Name:*

Middle Initial:

Last Name:*

Registrant 2 - First Name:

Middle Initial:

Last Name:

Company:*

Address:*

~Apt. or Suite No.
City:*

~~~
State:*

Zip Code:*

Country:*

Work Phone:*

Fax:

Cell Phone:

Category:*

Billing Information
Same As Registrant Info:

Must match name on Credit Card
First Name:

Middle Initial:

Last Name:

Address:

Apt. or Suite No.
City:

Apt. or Suite No.
State:

Zip Code:

Country:

Payment Information
Card Number:*

No dashes or spaces please
Expiration Month:*

Expiration Year:*

Card Type:*

CVV2:*

~Card Security Code
Advance Registration: 10% Discount on Registrations until 2/1/2012
 
Your convention badge and materials will be ready on Sunday, June 24 at 1:00pm in the Paris-Las Vegas Hotel, WSRCA Registration Desk in the Paris Foyer.

• Full Registration Package: Includes all ticketed events (unless otherwise specified), seminars, tradeshow exhibits for all three days.

• Second Full Registration Package: Includes all ticketed events (unless otherwise specified), seminars, tradeshow exhibits for all three days when a Full Registration Package is purchased.

• Daily Registration: Includes seminars and tradeshow exhibits for each specific day and the opportunity to purchase ticketed events at the lower rate.

• Safety Expo: Info to be completed by January 1

SHOW SPECIALS:
• Sunday Daily Registrations AND Safety Expo registrations include the Welcoming Reception and Lively/Silent Auction, Sunday evening.

• Safety Expo registrations receive complimentary Monday seminars and tradeshow entry.

• Tuesday Daily Registration is included in all RCI Registrations

• Free daily tradeshow entry available with coupons

• Ticketed Events (TE): Ticketed Events are indicated in the Convention Schedule as (Ticketed Event) are included in the Full and Second Registration Packages and are available for separate purchase by Daily Registration at discounted rates. They may also be purchased for full price by Free Pass attendees or nonregistrants. Full price tickets are listed in (parenthesis) on the Registration Housing Form.

• Separate Events & Workshops (SEW): The following list of events and workshops are NOT included in Full or Daily Registrations and may be purchased separated on the Registration & Housing Form:
Roof Consultants Institute Region IV Workshops
Spouse Programs (limited space)
Safety Expo
Davis Tournaments and Events
 
Full & Daily Registrations - BEST VALUE! 10% Discount Until 2/1/2012
Full Registration
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Second Full Registration
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Sunday, June 24th
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Monday, June 25th
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Tuesday, June 26th
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RCI Region IV Seminars
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Tradeshow Only Pass
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Safety Expo 2012
 
The Safety Expo planned for Saturday, June 23 and Sunday, June 24 is in its final stages of confirmation. If interested in receiving information for this segment of the Western Roofing Expo, please check the box below and we will contact you as soon as the arrangements have been confirmed.
 
Please send me Safety Expo Information

Individual Registration Items
Welcoming Reception
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Spouse Program - (Limited)
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Legislative Luncheon
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Annual Luncheon
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Housing Reservations
Housing Reservation deadline is May 22, 2012. After this date rooms may still be available, but on an “availability basis only” and rates may increase. Call WSRCA for up to date information (650-938-5441). For Suite information, please call WSRCA for availability, size and rates for suites. All room reservations must be made thru WSRCA for the secured rate discount.

Room rates are based on single/double occupancy. Additional persons will be charged at a rate of $30.00 per person per night, with a maximum of four (4) persons per guestroom.

All reservations must be guaranteed by a major credit card or a check made payable to the Paris Las Vegas Hotel or Bally’s Hotel for the first night’s deposit plus room tax (12%). It is the hotel’s policy to charge one nights room and tax upon booking. Reservations made with declined or invalid credit cards are subject to cancellation.

WSRCA does not charge your hotel room to your credit card; only the hotel will charge your credit card for your room. When you receive a Western Roofing Expo confirmation of registration, it will only show the number of rooms and room nights you have reserved , your arrival and departure dates along with any registrations you have purchased. Please review your confirmation carefully for accuracy. Any changes MUST be done directly with the WSRCA office by fax or email.
 
No Housing - Click Box Below:

Click check-box for NO HOUSING
Paris Las Vegas - $145.00 (+12% tax)
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Departure Date:

 
Bally`s Hotel - $112.00 (+12% Tax)
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Departure Date:

 
Bed Type:

Smoking/Non-Smoking:

Handicap Access

Occupant:

Occupant 2:

Occupant 3:

Occupant 4:

Davis Memorial Foundation Tournaments - Sunday: 6/24/2012
Golf Tournament
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Revere Golf Club presents a blend of beauty and challenge unlike any other in Southern Nevada. The Club offers unending, awe-inspiring views of the city below and mountains beyond and the Lexington’s stunning 7,143 yard, par 72 layout will test your skills.

 
…Location/Date/Time: Revere Golf Club at Anthem, Lexington Course, Sunday 6/24/12 @ 7:30am
…Registration Fee: $195.00/person. Foursome $780. Additional Foursomes-same company = $680.00 ($100 savings) Included: Cart, Range Balls, Breakfast and BBQ Lunch
…Club Rentals: $65. Incl 2 sleeves of balls
…Buses: Depart at 6:30am - $15.00/person
…Mulligans $20 each (max 4/person). Mulligan Raffle: Set of Callaway Irons (or equivalent)
…Free Raffle Prizes: See web page for prize listing

Clays & Trap Tournament - Limited to 50
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Pro Gun Club offers a twenty-one station, five star rated, sporting clays course with one five stand, one FITASC five stand, trap and skeet fields, rifle and pistol bays, and an archery field. The club is over 160 acres of rolling terrain offering a distinct challenge for shooters.
 
 
...Location/Date/Time: Pro Gun Club (formerly Desert Hills Shooting Club), Sunday 6/24/12 @ 9:00am
...Registration Fee: $195.00/person. Included: Breakfast, BBQ Lunch, 4 boxes of shotgun shells, golf carts
...Beretta Gun Rentals: $25
...Buses: Depart at 7:30am - $15.00/person
...Poker Run Tickets: $20 each. Poker Run Raffle: $500 gift certificate to Cabela`s
...Free Raffle Prizes: See web page for prize listing
 
Bus Rider
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Rentals
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Mulligans
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Poker Run Tickets
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Participant:

Participant 2:

Participant 3:

Participant 4:

Davis Memorial Foundation Annual Fundraiser
WIN a Mercedes Benz C300, OR a Harley Davidson Road King Classic, OR CASH $25,000!! Drawing on Tuesday, June 26, 2012 at the Western Roofing Expo, Paris Las Vegas Hotel, Tradeshow Floor at 5:30pm.

Buy a ticket for your chance to win the Grand Prize of: a 2012 Mercedes Benz C300 Sport Sedan. Don’t like luxury cars?? OR, if you love to ride motorcycles a Harley Davidson Road King Classic. Still not satisfied?? How about $25,000 CASH!! All proceeds go to benefit the Davis Memorial Foundation Scholarship Program.

…Tickets are $100 each with a maximum of 750 tickets to be sold
…Winner of the Grand Prize need not be present to win
…1st Prize = $500 Southwest Airlines voucher and 2nd Prize = $250 Southwest Airlines voucher. Winners MUST be present.
 
Annual Fundraiser Ticket
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WSRCA Membership - Discount Your Registration Costs!
Important: The undersigned firm hereby applies for membership in the Western States Roofing Contractors Association and certifies that the firm is actively engaged in the roofing contracting business and performs roofing, waterproofing, siding, and/or insulation work, or the firm/individual is engaged in the manufacturing and/or supplying of materials, equipment, or services used by roofing contractors or engaged in the design, specification, inspection, or consultation regarding roofing, roof decking, and roof systems. The undersigned agrees to abide by the by-laws of the Association as they are now in force or may hereafter be amended and to cooperate with fellow members in furthering the purpose and goals of the Association and in improving the roofing industry generally. Active members shall constitute the voting body of the Association. The following prices are your annual dues for one fiscal year. Upon receipt of your application, WSRCA will process it and send you a new member kit to the mailing address specified.
 
Same As Registrant (Section 1)

First Name:

Last Name:

Company:

Address:

Apt. or Suite No.
City:

~~~~~~
State:

Zip Code:

Country:

Work Phone:

Fax:

Cell Phone:

Email Address:

 
Contractor Member
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Associate Member
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Grand Total
GRAND TOTAL:
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