64th Annual SGS Fall Assembly Exhibitor Registration Step 1 of 4 25% Company InfoCompany Name* Company Website Primary Contact (Billing Contact)Primary Contact Name First Last Credentials Primary Contact Job Title Primary Contact Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Contact TelephonePrimary Contact Email* Exhibitor PackageExhibitor Options* Crystal Ballroom Booth - $1,500.00 Crystal Ballroom Foyer Booth - $1,500.00 Number of Booths*123Please Upload Your Company's Logo (.jpg, .png., .gif) Drop files here or Select files Accepted file types: jpg, png, gif, , Max. file size: 256 MB, Max. files: 1. Competitor Booth That You Do Not Want to be Seated Near: Representatives Staffing Your BoothTwo representatives are allowed with your exhibitor registration. Primary Booth Representative Contact(This information will be published and distributed to attendees)Primary Booth Representative Check if this is the same as the Primary Contact Primary Booth Rep Name First Last Credentials Primary Booth Rep Job Title Primary Booth Rep Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Primary Booth Rep PhonePrimary Booth Rep Email* Rep # 2 Name First Last Credentials Rep # 2 Job Title Additional representative(s) at your booth: ($150 per person) Optional - Additional booth representativesTwo booth representatives are allowed with exhibit package. Each additional booth representative is $150.Select the number of addt'l repsOne additional representative - $150.00 - $150.00Two additional representatives - $300.00 - $300.00Rep # 3 Name First Last Credentials Rep #3 Job Title Rep # 4 Name First Last Credentials Rep #4 Job Title Terms of Service* The SGS reserves the right to restrict exhibits, without refund, which may be deemed inappropriate, unsuitable or objectionable. Distribution of literature, samples, etc., in the exhibit area by firms that are not participating as paid exhibitors is strictly prohibited. No subletting of space is permitted without prior written consent of the SGS– email: admin@seagyn.org Exhibitors are responsible for shipping, storage, and installation of exhibit materials, and all costs involved. There is a $250 service fee on all cancellations. No Refunds for cancellations received after August 21, 2022. The SGS and Washington Athletic Club do not guarantee against theft or vandalism. Exhibitors shall indemnify and hold harmless the SGS and Washington Athletic Club of all liability (damage or accident) that might ensue from any cause in connection with transfer, installation, display, maintenance or removal of exhibits. In the event of fire, strikes or other uncontrollable circumstances, the contract for space will not be binding on either party. The SGS will not pay for special equipment, facilities and services ordered by technical exhibitors. Electrical and other apparatus must be operated so that the noise does not interfere with other exhibitors. All electrically-wired display material must comply with requirements of the National Board of Fire Underwriters. Aisles must be kept clear - all exhibits and representatives must stay within their exhibit space. Care must be taken by the exhibitor not to deface or destroy any part of the exhibit areas. In the event of property damage, the exhibiting company will be held responsible. Use of the name “SGS” or that of any officer of said Society, the group name or logo in recommendation of a product or services, is expressly prohibited. Table space not occupied by the close of the exhibit installation period as specified above, will be forfeited by the exhibitor, and this space may be resold, reassigned or used by conference management. I agree to the Terms of Service Coupon TOTAL $0.00 Payment Type Credit Card Check Check Number CREDIT CARD American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name INQUIRIES Contact Kimberly Conn, Association Executive, at the SGS office at 206-956-3652 or send emails to admin@seagyn.org Δ