Hyatt Regency Austin
EXHIBITOR REQUEST FORM
Conference Name: Academy of Surgical Research 2011 Conference
Exhibitor Name: ______
Booth #: ______
Method of Payment: (Credit card # or guest room) ______
If charging to guest room, Confirmation #______
If charging to a Credit Card:
Card Type: ______
Name on Card: ______
Card Number: ______
Expiration Date: ______
Exhibitor Needs
Box Delivery:
Number of Boxes:______
Please address all boxes/packages as follows:
(Client Name)
(Client Organization Name)
C/O Hyatt Regency Austin
208 Barton Springs Road
Austin, TX 78704
Hotel Contact Name
Group Meeting Dates
(Box ___of ___)
(If an exhibitor, please put booth # on boxes)
Due to limited storage, please do not send packages more than two (2) days prior to your event. Deliveries that arrive prior to this will be subject to a $50.00 storage fee per box.
Box Delivery Price Breakdown: (inclusive of ingress and egress)
Boxes 50 lbs or less - $5.00 / each
Boxes 50 lbs or more - $15.00 / each
Pallets / similar size - $75.00 / each
Pallets over 500+lbs - $125.00 / each
The Hotel does not accept any liability for equipment, goods, displays, or other materials that arrive or fail to arrive at the Hotel. The Group is responsible for insuring its property for loss or damage. All packages should be clearly marked with a return address.
High Speed Internet
Wired:______
Wireless:_____
($100 for Wireless, $200 for Wired per line, per day)
Please return to Rachael Geels via fax (512-480-2089) or email: