Company Contact Name:
Company name:
Contact phone:
Contact email:
Cancellation
Check One:
Change
Name of Person Changing/Cancelling
Name of Person attending instead:
New Attendee Title:
New Attendee Telephone:
New Attendee email:
Click here is first time attendee.
Note:  First change is complimentary.  All other changes incur a $75 administrative fee.
Code of Conduct, Cancellation and Change Policy
Prior to submitting your registration form, read the Code of Conduct,  Change and Cancellation and Waiver Information.  
Your submitted Registration Form indicates you have read, understand and accept all terms and conditions sited within
the Conference Waiver Information.  
Liability Release Waiver Information
My/Our registration indicates I/We agree to release the Utility Payment Conference and hotel, and each of their respective
officers, directors, agents, representatives, and employees (referred to collectively as "Releasees") from any and all
claims, actions, damages and liabilities, injury or loss that in any way are caused by, arise out of or result from my
participation in the Utility Payment Conference.
Photo Release
I/We hereby give the Utility Payment Conference and its delegated representatives the permission to photograph me
alone and/or with other attendees in conjunction with and for the conference.  I/We understand the pictures may be used
for the promotion of the conference.  Publications of photographs shall include, but is not limited to, the conference
website, future conferences, promotional brochures and flyers and other forms of media.
Hotel Reservation Release
I/We hereby give the Utility Payment Conference and its delegated representatives permission to inquire of the hotel
information regarding my booked reservation.  In addition, the conference hotel(s) has my/our permission to disclose
my/our reservation information to the conference's delegated representation.
www.paymentconference.com
Utility Payment Conference