b'October 16 - 18, 2017CONTRACTOR REGISTRATION FORM Americas Center - St. Louis, MO Please print clearly or Register Online at www.mrca.org. Use a separate form for each registrant, and duplicate form as necessary. Company Name____________________________________________________________________________________________________ Full Name ________________________________________________________First Name for Badge ______________________________ Title _______________________________Unique Email (required)_________________________________________________________ Company Address ___________________________________________________________________________________________________ City _______________________________________State _______ Zip ____________Country ___________________________________ Work Phone ____________________________________________Cell Phone________________________________________________ Spouse/Guest Name __________________________First Name for Badge _____________________ Phone ________________________ Member FULL RegistrationActivities Requiring Separate Registration Fee Cont. Member Full Registration $350 AdditionalMember Full Registration* $125Spouse and Guest Outing in St. Louis Includes MRCA Welcome Reception, Foundation Auction, KeynoteWednesday, October 17th10:00 am2:00 pm Address, MRCA Membership Meeting, Educational Sessions, MealsTickets include transportation to and from restaurant, lunch, tour, taxes and and Access to Exhibit Hall.gratuities. Space is limited to 20 Registrants. *Discount is available only if registrants are from the same company. All registrants must______ No. of Tickets at $125.00 each = $____________ complete separate registration forms. The MRCA Member price is also being extended toSubtotal C $_______________ Roofing & Siding Contractors Alliance (RSCA) Members.Non-Member Individual Full Registration $450 per personGeneral and Steep Slope Educational Sessions For space and meal planning purposes, please check which sessionsJoin and Register Option for Contractorsyou plan on attending. Become an MRCA Member today and receive Silver Level Membership for 2017 - 2018 and1 complimentaryFULL registration.Monday, October 16thGeneral Educational Sessions Join and Register$795 1:00 - 3:00 pmMRCA Women in Roofing Roundtables Additional New Member Registration$1254:00 - 5:00 pm Understanding Your Overhead 1-Day of Conference Registration 5:00 - 5:30 pm New Member / 1st Time Attendee Reception Includes 1 day of General Educational Sessions and Access to the Exhibit Hall. All registrants must be from the same member company,Monday, October 16thArrowhead Steep Slope University Sessions attend the same day, and submit forms together to receive the4:00 - 5:00 pm Understanding Your Overhead5:00 - 7:00 pm Ventilation Program member discount. All registrants must complete separate registration forms.Tuesday, October 17th General Educational Sessions8:1510:15 amMRCA Keynote Speaker & Awards Ceremony Check the day you will attend: Monday Tuesday Wednesday 10:1511:15 amPsychological Selling 1-Day Member Individual Registration $150 11:15 am12:15 pmYCC/PCC Around the Roof 1-Day Non-Member Individual Registration $1955:30 pm8:30 pmWelcome Reception & Foundation Auction Exhibit Hall Access Only RegistrationTuesday, October 17th Arrowhead Steep Slope University Sessions Contractors, Consultants, Specifiers, Code Officials,Engineers, Architects, Insurance Agents are FREE 10:15 - 11:15 amUnderstanding Your Overhead & Financials Non-Exhibiting Suppliers are $200 per person 11:30 am - 12:15 pmOSHA for Steep Slope ContractorsSpouse and Guest RegistrationWednesday, October 18thGeneral Educational Sessions Includes MRCA Welcome Reception, Foundation Auction, and Access 8:009:30 amPresidents Panelto Exhibit Hall.(See Block C for Spouse/Guest Outing Registration) $125 9:4510:45 pmSubcontracting in Roofing 11:0012:30 pmT&R Lunch and LearnSubtotal A $_______________ 2:00 - 3:00 pmYCC Hosted War of the WordsPanel DiscussionActivities Requiring Separate Registration FeeWednesday, October 18thArrowhead Steep Slope University Sessions9:00 - 10:00 amDealing with Insurance Companies Arrowhead Steep Slope University for Contractors 10:15 - 11:15 amCrew Leadership & Communication (Includes Steep Slope Educational Courses, Meals & Access to Exhibit Hall) $50 per person Special Requests YCC Bowl-O-Rama Foundation Fundraiser OutingThis is my First MRCA Conference & ExpoMonday, October 16th7:30 - 9:30 pm I require special assistance onsite. Please contact me.$40 per person I have a dietary preference for meals. Please specify:CERTA Train-the-Trainer Course for NEW Trainers and Reauthorization (Includes Meals & Access to Exhibit Hall) __________________________________________ ReauthorizationTuesday, October 17th 7:00 am - 2:00 pmNew TrainersTuesday, October 17th 7:00 am - 6:00 pm Total Payment DueA + B + C$______________ $375 per person for MRCA, NRCA and RSCA$495 per person for Non-Members Check to MRCAVisaMCAmExpDiscover Card # ______________________________________Exp. Date _______ CERTA Applicator Course(Includes Meals & Access to Exhibit Hall) Name on Card____________________________ Billing Zip Code _______ Wednesday, October 18th7:30 - 11:30 am and 1:00 - 5:00 pm$325 per person for MRCA, NRCA and RSCA MembersCancellation PolicyAll cancellations must be received in writing. A $15 $475 per person for Non-Members processing fee applies to all cancellations. No refunds will be given after October 1, 2017.Subtotal B $_______________ All refunds will be processed after the conference. 18 www.mrca.orgMidwest Roofer'