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Title Sponsors: Liberty Mutual Insurance / Safeco Insurance<br />
Members of the Liberty Mutual Group<br />
The Independent Insurance <strong>Agent</strong>s & Brok<br />
oker<br />
ers s of <strong>Oregon</strong><br />
91st h Annual Convention & Trade Show<br />
August 25 - August 27, <strong>2019</strong>, Eagle Crest Resort, Redmond, <strong>Oregon</strong><br />
“THE NEXT GENERATION ”<br />
Full Registration/<strong>Agent</strong>/ Company Personnel<br />
Name: Agency/Co: $299.00<br />
Phone: Fax: Email:<br />
Golf / Preferred Foursome: $ 84.00<br />
Spouse / Guest $169.00<br />
Golf / Preferred Foursome: $ 84.00<br />
Additional Full <strong>Agent</strong> Registration(s) And Young <strong>Agent</strong>s<br />
Name: Agency/Co: $49.00<br />
Phone: Fax: Email:<br />
Golf / Preferred Foursome:<br />
FREE<br />
Spouse / Guest: $49.00<br />
Golf / Preferred Foursome:<br />
FREE<br />
For additional attendees please photo copy this registration form.<br />
Limited Registration Packages<br />
Sunday “FIESTA” (per person)<br />
Monday Banquet “ONLY” (per person)<br />
Ethics - Monday, August 26th - Includes Lunch with Exhibitors,<br />
Raffle & Door Prizes<br />
Law - Tuesday, August 27th - Includes Champagne Breakfast<br />
Young <strong>Agent</strong> Event - Monday, August 27th - Company/Vendors<br />
Young <strong>Agent</strong> Event - Monday, August 27th - Putting Golf (With a paid Young<br />
<strong>Agent</strong> registration)<br />
Monday Workshop with John Chapin Includes Lunch with Exhibitors, Raffle &<br />
Door Prizes<br />
Champagne Breakfast “ONLY”, Tuesday, August 27th<br />
Kids Registration<br />
Kids 6 - 18 years ---------------------------------#<br />
Includes all meals and social functions. Kids 5 and under are FREE.<br />
Name(s) & Age(s) of Children:<br />
$60.00<br />
$75.00<br />
$60.00<br />
$60.00<br />
$20.00<br />
FREE<br />
$89.00<br />
$40.00<br />
X $75.00 each TOTAL<br />
TOTAL AMOUNT<br />
If paying by Credit Card, please complete the following information. A 5% service charge will apply on all credit card<br />
payments. Checks should be made payable to the IIABO and mailed to IIABO, 6 Centerpointe Dr #430, Lake Oswego, OR<br />
97035<br />
Credit Card #: Exp Date: / Vcode:<br />
Card Billing Address:<br />
Name on Card:<br />
Signature:<br />
Members of the Liberty Mutual Group<br />
Title Sponsors: Liberty Mutual Insurance / Safeco Insurance<br />
REFUNDS IN FULL WILL BE MADE ON ANY WRITTEN CANCELLATION RECEIVED IN THE IIABO OFFICE BY<br />
JULY 1ST. REFUNDS BETWEEN JULY 1ST AND AUGUST 1ST WILL INCURE A FEE OF $150 AND CAN BE TRANS-<br />
FERRED TO ANOTHER EVENT OR INDIVIDUAL. NO REFUNDS WILL BE GIVEN AFTER AUGUST 1ST.<br />
HOTEL RESERVATIONS ARE NOT INCLUDED IN REGISTRATION FEES, CONTACT EAGLE CREST RESORT 855.200.3551.<br />
3 The <strong>Oregon</strong> <strong>Agent</strong> • Winter 2017<br />
18 The <strong>Oregon</strong> <strong>Agent</strong> • <strong>Summer</strong> <strong>2019</strong>
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