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PhotoHistory XIV October 16-18, 2009
Presented by THE PHOTOGRAPHIC HISTORICAL SOCIETY at George Eastman House, International Museum of Photography and Film Rochester, New York Advance Registration Form Click here to obtain this form as a WORD document Symposium or Trade Show Dealer Attendees Please Indicate name as it should appear on badge. First Name Last Name 1) 2) 3) Mailing Address: Street Address or P.O. Box ______________________________________________________ City __________________________________ State (or Province) _______________________ Zip (Postal) Code _______________________ Country ________________________________ Telephone (_____)_____________________ e-mail address ___________________________ *Groups of 10 or more may qualify for a discount. Please contact Marian Early at (585) 232-3380 or e-mail PhotohistoryXIV@frontiernet.net for information. Options Cost Per Person Number Attending Amount Symposium Registration (Includes reception, symposium, lunch and trade show general admission) $ 95.00 Student Registration (with school ID) (Includes reception, symposium, lunch and trade show general admission) $ 50.00 School Name Banquet Sit down buffet at Double tree Hotel $ 32.00 Trade Show Tables (see terms on page 2) 1. Early Saver Rate (payment received by 9/18/09) $ 80.00 2. Regular Rate (payment received after 9/18/09)) $ 95.00 $ Trade Show Early Admission 1. With Advance Registration $ 35.00 2. Payment at Door $ 40.00 Please make checks payable to: The Photographic Historical Society, Inc. (U.S. funds only, please!) TOTAL $ Send payment to: The Photographic Historical Society: PhotoHistory XIV P.O. Box 10342 Rochester, N Y 14610 Trade Show Dealer Information Dealer / Company Name________________________________________________________ Assistant’s Name(s) (1 additional person per table)____________________________________ Mailing Address: Street Address or P.O. Box ______________________________________________________ City__________________________________ State (or Province) _______________________ Zip (Postal) Code _______________________Country ________________________________ Telephone (_____)______________________ e-mail address: ___________________________ Trade Show Terms: Trade show dealer tables shall be 3’ x 8’ for use in exhibiting, trading or sale of photographic items which are antique, collectible, or associated with the pursuit of such interests. Furthermore, I agree to be bound by the following regulations: 1) I will receive two admission badges with the first table I rent, and one additional badge with each additional table rented. No person over the age of ten will be admitted during set up time without a badge. 2) I agree to comply with all applicable Federal, State and local laws. 3) I will be responsible for observing the conditions of this contract, and for all acts of my assistants. I hereby release The Photographic Historical Society, Inc. and the Double Tree Hotel from all claims of damage or injury to property or persons from any cause whatsoever. 4) I understand that The Photographic Historical Society, Inc. and Double Tree Hotel shall have full power to interpret, enforce and amend these regulations, and that their decision is final. 5) Set up time is 8:00 AM to 10:00 AM; show hours are 10:00 AM to 4:00 PM. No merchandise will be removed prior to the end of the show. All merchandise must be removed by 6:00 PM. “Early Admission” buyers will be admitted at 8:00 AM. 6) This show is limited to 80 tables – payment required to reserve tables. 7) Two chairs will be provided per table. 8) Note: If you would like a table next to another dealer, please send registration under one name and indicate the number of tables required. Dealer Signature: _____________________________________Date ____________________ Please make checks payable to: The Photographic Historical Society, Inc. (U.S. funds only, please!) Send payment to: The Photographic Historical Society: PhotoHistory XIV P.O. Box 10342 Rochester, N Y 14610 |