MIDWEST INSULATION CONTRACTORS ASSOCIATION 
ANNUAL CONVENTION REGISTRATION FORM 
The Everline Resort & Spa – Olympic Valley, CA 
June 15-19, 2026 
 
Please print clearly or Register and Pay Securely Online at www.micainsulation.org. 
Use a separate form for each registration, and duplicate form as necessary. 
 
 
___________________________________________________________________________________________________________________ 
COMPANY NAME 
 
 
___________________________________________________________________________________________________________________ 
ATTENDEE NAME 
 
 
 
 
 
SPOUSE/GUEST NAME 
 
___________________________________________________________________________________________________________________ 
CHILDREN   NAME(S) if Registered 
 
___________________________________________________________________________________________________________________ 
BILLING ADDRESS 
 
 
 
 
 
CITY        
 
STATE  
      ZIP 
 
___________________________________________________________________________________________________________________ 
E-MAIL  
 
 
 
OFFICE PHONE  
 
 
CELL PHONE  
 
 
 
 
 
First Time Attendee              Yes    No 
 
CONFERENCE REGISTRATION: 
 
 
 
 
 
 
 
 
Number  
  Total 
First Attendee from MICA Member Firm - $895.00  
 
 
  
 
 
 
_______          $__________ 
Each additional Attendee from the Same Member Firm - $825.00 
 
 
  
 
 
_______          $__________ 
First Couple from MICA Member Firm (Member & Spouse/Guest) - $1,720.00  
  
 
 
_______          $__________ 
Each additional Couple from the Same Member Firm - $1,650.00 
 
 
 
  
 
_______          $__________ 
Non-Member Attendees - $925.00 Per Person 
 
 
 
 
 
 
 
_______          $__________ 
Children Under 18 - $0.00 No Charge (Welcome Reception Only) 
 
 
 
 
 
_______         $__________ 
 
Member/Spouse Opening Breakfast: 
I/We (will) (will not) attend the Opening Session Breakfast on Wednesday, June 17th.  The Number Attending is 
_______ 
 
Gala Dinner/Dance: 
I/We (will) (will not) attend the Gala Dinner/Dance on Thursday Evening, June 18th.  The Number Attending is  
_______ 
 
    
ADDITIONAL ACTIVITIES: 
 
 
28th Annual “Mick Van Horn Memorial” Scramble Golf Tournament: 
 
Golf Tournament Registration - $180.00   
Name: _______________________________ Handicap __________                         $__________   
Golf Club Rental - $75.00 
Please Specify: (Men/Womens Clubs) (Left/Right-Handed)  
 
 
 
        $__________ 
Golf Tournament Registration - $180.00   
Name: _______________________________ Handicap __________                         $__________   
Golf Club Rental - $75.00 
Please Specify: (Men/Womens Clubs) (Left/Right-Handed)  
 
 
 
        $__________ 
Golf Registration Fee includes lunch, 18 holes of golf, shared golf cart, complimentary use of practice and range area, and prizes.  Slacks or 
Bermuda length shorts, collared shirt and non-metal spiked golf or tennis shoes are required.  Cut-offs and T-shirts are prohibited anywhere on the 
premises. 
 
 
Golf Alternative Activity: Lake Tahoe Fly Fishing School 
Cast ‘n Catch class at the Everline Resort in Olympic Valley (3 hours) is great for beginners to intermediate anglers and for those who need a 
refresher course. Learn basic casts on dry land and then move to the stocked pond to practice what you learned and try to catch a fish. All this takes 
place on the golf course with breathtaking views of beautiful Olympic Valley. The Registration fee includes all fishing gear, licenses, instructors, 
taxes, gratuity for the instructors and the 15% Resort Fee.   
 
 $299.00         Name: __________________________    
 $299.00         Name: __________________________   
 
 $299.00         Name: __________________________    
 $299.00         Name: __________________________   
 
 
MICA MESSENGER
15
6 9 T H  A N N U A L  C O N F E R E N C E
mica conference

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