Sponsorship Registration (For CALA Provider Members Only) Contact Information This contact information does not need to be an attendee. Please include the contact information for the individual that could respond to questions regarding registrations and billing. Name: Title: Company: Address: City, State, Zip: Phone: Email (required): Choose your Sponsor Level Platinum ($14,500)Gold ($7,000)Silver ($4,800)Bronze ($2,500) Platinum: 36 full conference registrations or 40 Early Bird registrations* Gold: 15 full conference registrations or 18 Early Bird registrations* Silver: 10 full conference registrations or 12 Early Bird registrations* Bronze: 5 full conference registrations or 6 Early Bird registrations* *CALA must receive your registration and payment by May 5, 2017 for the early bird discount. Payment Check (Make payable to CALA)Credit Card (Visa, MC, AMEX) Credit Card Number: Cardholder Name: Expiration Date: If opting to pay by check, please mail to: CALA, 455 Capitol Mall, Ste 222, Sacramento, CA 95814. Checks must be received 7 days prior to the day of the event. Attendee List Please include the Name, Job Title, Community and Email address for any attendees you know are attending under your sponsorship. If you do not have a complete list yet, no problem! Just submit the names you do have and you can add additional ones later by contacting CALA staff. Name Title Community Email Confirmation – You will receive written confirmation of your registration from CALA within 10 days of receipt. Non-Members – CALA memberships are companywide. If you are not a member, please pay the non-member rates, or join CALA to receive member rates. Conference Discounts – CALA must receive your registration and payment by May 5, 2017 for the early bird discount. Attendee Roster – CALA must receive your registration no later than May 19, 2017 to be listed in the official pre-registered roster, which will be available on-site. Cancellation Policy – Cancellations received in writing by 5:00 p.m. 11 business days before the event will receive a refund less a $50 administrative charge. Cancellations received 6 -10 business days before the event are not refundable (regardless of registration date), but credit may be given for future CALA educational offerings; substitute attendees are encouraged. No refunds or credits will be given for cancellations received thereafter. No-shows will be billed. Remittance – Payment and registration can be mailed or faxed to CALA 455 Capitol Mall, Suite 222, Sacramento, CA 95814, Fax (916) 448-1659. On-site CALA Photographer – Please be advised that a CALA photographer will be taking photos at the conference. As a registered participant, you agree to be included in photographs that may be used for future publicity or marketing materials. CALA Contact - All registered attendees agree to receive CALA correspondence via fax, e-mail or phone. Please call 916-448-1900 if you require special accessibility or accommodations at this function. If you are a vegetarian or first-time attendee, please let us know by emailing kem@CAassistedliving.org.