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RBMA Home > Exhibiting and Advertising

RBMA Radiology Summit — Application for Exhibit Space

Sponsor (Please only add item(s) not included in your sponsor agreement.)
2011 Fall Educational Conference Returning Exhibitor
New Exhibitor

EXHIBITOR INFORMATION

Contact Information (for all correspondence)
Firm or Company Name:
Contact Person:
Title:
Address:
 
City:
State:
Zip Code:
Telephone: ( ) -
Fax: ( ) -
Email Address:
Website:
Cell Phone: ( ) -
If you need special assistance,
please specify:
   
Please indicate here the exact copy for your company description in the Conference Guide: (Only provide information if different from above)
Firm or Company Name:
Contact Person:
Title:
Address:
 
City:
State:
Zip Code:
Telephone: ( ) -
Fax: ( ) -
Email Address:
Website:
   
Company product or service description (50 or fewer words):
   

SPACE REQUIREMENTS

We hereby authorize you to reserve for our use the following exhibit space(s) in the Exhibit Hall:
Booth selection (see floor plan):
RBMA will make every effort to assign booth requested. Final booth assignments are determined at the discretion of the RBMA event management.		 1. 2.
3. 4.
5.

PREMIUM BOOTH PRICING
There is an additional $300 fee for a premium booth. If you select and receive a premium booth space, please be aware that you will be responsible for the additional fee after you are assigned your booth. If you paid by credit card, the card will be charged for the additional amount. If you paid by check, you will be invoiced for the additional amount.

 I have read the "Premium Booth Pricing" and am aware of the potential charge should I receive a premium booth space.
   
We do wish to be situated near the following companies*:
We do not wish to be situated near the following companies*:
* Must list company names.  

PAYMENT

Note to Sponsors:
Please only add item(s) not included in your sponsor agreement.
Booth Space
Each individual booth space is 10’ x 10’ 		 
Booth Rate:
NonMember
$2500 Per Booth
Booth(s):
 # Number of Booths
  Sponsors: Only specify booth(s) not included in your sponsor agreement.
   
Marketing  
Pre-Conference Registration List: $100 per rental
Post-Conference Registration List: $100 per rental
Pre- and Post-Conference Registration Lists: $150 for both per rental

Upgrade my listing in the Conference Guide
to include my company logo.
Upload your logo here:

$250

RBMA Movie Name Game: $75
Meter Board Advertising: $500
e-Flash: $1400
Conference Guide Ad:
   
Pre-conference Session  
Sunday, May 20, 2012
4-5 p.m.
Interpreting RBMA Survey Results and Applying Them to Your Practice

# $FREE
Name #1:
E-mail Address:
Name #2:
E-mail Address:
   
Special Events  
Networking on the Green: RBMA Golf Tournament
Sunday, May 20, 2012:		 # $85 per person
Name of golfer #1:
E-mail Address:
Handicap:
   
Name of golfer #2:
E-mail Address:
Handicap:
   
Name of golfer #3:
E-mail Address:
Handicap:
   
Networking  
RBMA Luncheon* - Monday, May 21, 2012: # No Charge *
RBMA Luncheon* - Tuesday, May 22, 2012: # No Charge *
*Number of luncheon attendees not to exceed number of exhibitor reps.  
 

REPRESENTATIVE REGISTRATION

All representatives must be registered. Representatives must be employees of your company. Registered exhibitors are entitled and encouraged to attend all RBMA educational sessions and food and beverage events. (Note: special events and pre-conference education sessions require a separate fee.)

RBMA Corporate Members receive two (2) complimentary representative registrations per booth rented. Members may register up to two additional company representatives for $300 per person.

Non-members receive one (1) complimentary representative registration per booth rented. Non-members may register one additional company representative for $300.

Any company staff above the allowed number wishing to attend the RBMA conference may attend and register as an attendee at the attendee rate.

Name:
E-mail Address:
Emergency Contact:
Emergency Phone: ( ) -
Status:
   
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E-mail Address:
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E-mail Address:
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E-mail Address:
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ACCEPTANCE OF RULES: It is agreed that this application and contract resulting from its acceptance and confirmed assignment of space shall be subject to the published rules and regulations.

PHOTO RELEASE: RBMA reserves the right to photograph conference activities for use in publications, including electronic publications, or in audio-visual presentations, promotional literature, advertising, or in other similar ways. I hereby give RBMA and their legal representatives the right and permission to publish, without charge, photographs taken which may include our company booth, products or personnel.

LIABILITY WAIVER: I agree and acknowledge that I am undertaking participation in RBMA events and activities as my own free and intentional act and I am fully aware that possible physical injury might occur to me as a result of my participation in these events. I give this acknowledgement freely and knowingly and that I am, as a result, able to participate in RBMA events and I do hereby assume responsibility for my own well-being.

TERMS OF PAYMENT AND CANCELLATION: Applications must be accompanied by payment in full per space reserved. In the event of cancellation of a booth reservation by the exhibitor prior to April 20, 2012, the liability of the association shall be limited to the refunding of the amount of rental paid, less a $150 administrative fee. Cancellation by the exhibitor after that date will result in forfeiture of the required payment. Cancellation by the exhibitor must be in writing. In case of cancellation of the meeting for reasons beyond the control of the RBMA, it is understood that the liability of the association shall be limited to the refund of the amount paid. No refunds or cancellations for events requiring additional fees will be made after April 20, 2012.

By selecting this box, I agree to the above Terms and Conditions.

 

METHOD OF PAYMENT

Must be paid in full before a booth space can be assigned.
Credit Card:

       
Credit Card # (numbers only):
Exp. Date (mo/yr): /
(After submitting, your credit card will be charged immediately.)