Page 23 - Your Home and Mine June/July

SIGN ME UP! | REGISTRATION DEADLINE IS FRIDAY, AUGUST 14th.
NAME
COMPANY
PHONE
EMAIL
NUMBER OF ATTENDEES
CHECK ENCLOSED CREDIT CARD # EXPIRATION DATE CARDHOLDER NAME CARDHOLDER ZIPCODE SIGNATURE
BILL ME
VISA/MC/DISC/AMEX CVV
NAMES
Please fax this form to 859-277-9187, email to reservations@greaterlaa.com, or register online at www.greaterlaa.com. Please note: All registration forms are consid- ered binding contracts between the GLAA and registered attendees. In the event of a cancellation, no refunds or credits will be given if cancelled after the registration deadline has passed. Registrants of the GLAA event understand that publicity photographs may be taken during the event. By registering for this event, you hereby give permission that photos containing your image/likeness ma be used for publicity or general information purposes including publication on the GLAA web site or within other publicity which may be seen by the general public. The GLAA will not seek any further permission nor provide any notification before using such photos.