LMR April 2021

- REGISTRATION FORM-
Louisiana Municipal Association
4 4 th Annual Municipal Day Crawfish Boil
Wednesday, May 5, 2021
Drusilla Place Catering
3482 Drusilla Lane, Baton Rouge, LA 70809
NAME
BADGE NAME
TITLE
MUNICIPALITY
ADDRESS
(STREET OR P.O. BOX) (CITY) (STATE) (ZIP CODE)
TELEPHONE ( ) FAX ( )
EMAIL
GUEST NAME
DELEGATE CRAWFISH BOIL FEE: $30 per delegate, elected/appointed
official or municipal employee
GUEST CRAWFISH BOIL FEE: $30 per guest of delegate
NON-MEMBER CRAWFISH BOIL FEE: $50 per non-municipal participant
DISCLAIMER:
In registering for and attending this event, I agree to abide by state and local
health mandates as well as any rules put in place by the Louisiana Municipal
Association or event venues. I understand that by attending this event in person,
it is possible that I may be exposed to coronavirus and I hereby assume that risk.
YES, I AGREE
NO, I DO NOT AGREE
ACCOMMODATIONS:
A block of rooms has been reserved at the Crowne Plaza Hotel at a rate of $114.95
Single/Double. Please call (225) 925- 2244 to make your reservations and mention
that you are with Louisiana Municipal Association’s Municipal Day to secure this
special rate. The group code for reservations is ‘LMA’. Hotel check- in time is
4:00 p.m. and check- out is 11:00 a.m. unless special arrangements are made in
advance.
REFUND POLICY:
Registration fees are non-refundable. An administrative fee of $10 per
registration will be charged for all cancellations, including medical emergencies.
No refunds will be given after April 21 (two weeks prior to the start of the event).
Refunds will be issued only if the LMA office receives your cancellation request
in the form of a letter on your official letterhead mailed, emailed, faxed, or
delivered to our office with a postmark date no later than April 21. Telephone
requests for refunds are not accepted. There will be no exceptions to this policy.
Complete this form and return with
your registration fee payment in full,
no later than April 21, 2021 .
Registration forms sent without
payment in full will not be
accepted.
MAKE CHECKS PAYABLE TO:
Louisiana Municipal Association
Municipal Day
P.O. Box 4327
Baton Rouge, LA 70821
REGISTER ONLINE:
WWW.LMA.ORG
HAVE A QUESTION?
Contact: Nikki Samrow, P.O. Box 4327, Baton Rouge, LA 70821, (225) 344- 5001 Phone, (225) 344- 3057 Fax, nsamrow@lma.org
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LMR | APRIL 2021