Conference Exhibitor Registration Form

SEND TO:

READING REFORM FOUNDATION of New York

New York , NY � 10019

TEL: 212-307-7320������� FAX: 212-307-0449

email: [email protected]

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I will need ________ display tables.

I will/not need an ________ electrical outlet.

I have enclosed a check in the amount of $_________________.

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NAME OF COMPANY OR ORGANIZATION

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ADDRESS

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PERSON IN CHARGE OF EXHIBIT

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ADDRESS

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(______) _________________________________________

TELEPHONE

(______) _________________________________________

FAX

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EMAIL

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Exhibitor assumes entire responsibility and hereby agrees to protect, indemnify, defend and save Reading Reform Foundation of New York, New York Hilton & Towers, and their employees and agents harmless against all claims, losses and damages to persons or property, governmental charges or fines and attorney�s fees arising out of or caused by exhibitor�s installation, removal, maintenance, occupancy or use of the exhibition premises or a part thereof, excluding any such liability caused by the sole negligence of the New York Hilton & Towers, its employees and agents.� In addition, exhibitor acknowledges that Reading Reform Foundation and New York Hilton & Towers do not maintain insurance covering exhibitor�s property and that it is the sole responsibility of the exhibitor to obtain business interruption and damage insurance covering such losses by exhibitor.

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COMPANY NAME

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AUTHORIZED SIGNATURE

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