WBASNY Convention 2017 Registration Brochure

� Weekend Children’s Package (12 and under): (Friday, May 19 - Sunday, May 21) Includes Refreshment Breaks, Exhibits, Friday Reception and Awards Dinner, Saturday Breakfast, Lunch, Reception and Installation Dinner and Sunday Plenary Breakfast Meeting Name(s) of Child(ren): __________________________________________________________

$ 75 = $ _________

C LEAN THE W ORLD - O NE P ROJECT — I plan to participate:

�� Yes

�� No

CLE P ROGRAMS AND S EMINARS — I plan to attend the following CLE programs:

Friday, May 19

Saturday, May 20

�� Representing Your Clients Effectively in Arbitration �� Start - Up Ventures - Best Entity Choice �� Introduction to Reproductive Technology �� Stand Out When You Stand Up in Court

�� Leveling the Playing Field �� Same - Sex Marriages

�� Hot Topics in MHL Article 81 Guardianships �� Women Held to a Higher Ethical Standard

I NDIVIDUAL F UNCTIONS

Thursday Dattilo Italian Dinner Thursday Paint and Sip Party

# ____ X $ 40 # ____ X $ 35 # ____ X $ 40 # ____ X $ 175 # ____ X $ 20 # ____ X $ 29 # ____ X $ 175 # ____ X $ 0 # ____ X $ 75

= $ _________ = $ _________ = $ _________ = $ _________ = $ _________ = $ _________ = $ _________

Friday Golf Outing

Friday Reception and Dinner

Saturday Mystic Historic Harbor Tour

Saturday Essex Train & Riverboat Excursion

Saturday Reception and Dinner

Sunday Healthy Walk

Continuing Legal Education (per program) (Please indicate which CLE you plan to attend on reverse side of this form)

= $ _________

$ _________

TOTAL

Please indicate any special needs:

� vegetarian meals

PAYMENT: � Enclosed is my check, made payable to “WBASNY”, together with my registration form. Mail to: WBASNY Convention 2017, Post Office Box 936, Planetarium Station, New York, NY 10024 - 0546. � Please charge to: American Express _____ MasterCard _____ Visa _____ Name on Card: _____________________________________________________ Billing Address: _____________________________________________________ Card #: _____________________________________________ Expiration Date: _______ / _______ Signature: ___________________________________________ CVS#: __________ � If paying by credit card, you may fax your registration to: (212) 721 - 1620 or register on - line at: www.wbasny.org . � Inquiries should be directed to: Linda Chiaverini at (212) 362 - 4445 or events@wbasny.org .

FOR OFFICE USE ONLY Member ID: _______________ Reg ID: _______________ Amt. PD: ________________ Received: _______________ Member ID: _______________ Reg ID: _______________ Payment : _______________ Entered: ________________

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