Exhibitor Registration Form

The fee of $1,000 includes two complimentary registrations for representatives. Checks (credit cards not accepted) should be made payable to SAWCA. Mail to: SAWCA, Post Office Box 11697, Daytona Beach, FL 32120-1697.

Space is offered on a first-come, first-served basis. Upon SAWCA’s receipt of payment, exhibitors will receive an exhibitor decorator kit, which includes a layout of convention booth spaces from which exhibitor’s will be able to choose their booth’s location. For additional information regarding the exhibit area, contact the SAWCA office at (904) 252-2013.

Booth setup is in the Exhibitor area on Sunday, July 5th from 10:00 a.m. to 12:00 noon. Tear-down will be on Wednesday, July 8th at 12:00 noon.

Company Name:__________________________________________________________

Contact Person: __________________________ Title:____________________________

Address:________________________________________________________________

City:___________________________ State:__________________ Zip:______________

Telephone: (        )_____________________ Fax: (        )___________________________

Complimentary Registrant #1: ________________________________________________

Complimentary Registrant #2: ________________________________________________

Registration Fee of $1,000 Includes:

8 X 10 Booth
6’ Draped Table & 2 Chairs
Identification Sign
Registration for 2 Representatives
24-Hour Security

Exhibitor Insurance/Hold Harmless Clause

Exhibitor assumes entire responsibility and hereby agrees to protect, defend, save and hold harmless the Southern Association of Workers’ Compensation Administrators (SAWCA), its members, employees and agents, the Collyer Company and its employees and agents and The Grove Park Inn against all claims, losses and damages to persons or property, governmental charges or fines and attorneys fees arising out of or caused by exhibitor’s installation, removal, maintenance, occupancy or use of the exhibition premises or part thereof, excluding any such liability caused by the sole negligence or concurrent comparative negligence of The Grove Park Inn and its employees and agents, the Collyer Company and its employees and agents, as well as SAWCA, its members, employees and agents.

In addition, exhibitor acknowledges that The Grove Park Inn, the Collyer Company and SAWCA do not maintain insurance covering exhibitor’s property or potential liabilities and that it is the sole responsibility of the exhibitor to obtain business interruption insurance, property damage insurance and liability insurance covering such losses by exhibitor. Exhibitor shall obtain and keep in force during the term of the installation and use of the exhibit premises, policies of comprehensive general liability insurance and contractual liability insurance insuring and specifically referring to contractual liability set forth in the foregoing paragraphs hereof, in an amount not less than $1,000,000.00 combined single limit for personal injury and property damages. The Grove Park Inn, SAWCA, and the Collyer Company shall be included in such policies as additionally named insureds for this convention only.

I have read, understood and agree to abide by the terms listed herein.

Authorized signature:____________________________________ Date: ____________


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