Complete Both Pages 1 and 2 of Registration Form and Send with Payment to CFDA

Registration Form, Page 1  2017 Combined Convention
Hosted by the Colorado Funeral Directors Association in partnership with the Wyoming Funeral Directors Association / July 20-23, 2017
Embassy Suites Denver Downtown, Colorado
PLEASE PRINT LEGIBLY OR TYPE ALL INFORMATION BELOW / Business Type: Funeral Establishment Crematory Cemetery Supplier/Vendor
Business Name
Location address / City/State/Zip
Email (for confirmation) / Primary Contact Person
Office Phone / Fax
Registrant Names & RSVP
Please print name for each registrant below and check box(es) in the labeled columns for each event he/she plans to attend. Calculate registration fees on Page 2 of this form.Photocopy this form for additional registrants. / Certification Credential
or License Type / OPTIONAL PURCHASES / (A) FULL CONVENTION / (I, J, K) Single or 1-Day
Limited Admission
(G) Thursday Afternoon
Pre-Con Workshop / (H) Friday Morning
Pre-Con Workshop / (I) Saturday Take Me
Out to the Ballgame / (E) Friday Exhibits, Sessions & Reception / (F) Saturday Exhibits
Sessions & Lunch / Sunday Roundtable Discussions
Check box for each event to attend 
First Name / Last Name
1
2
3
4
5
6

Registration fees are based on membership in the CFDA or WyFDA. Select the level below that best applies: 11/17/2018 11:39 AM

MEMBER: An employee of a Funeral Establishment that is a Member of CFDA or WyFDA. / Complete both Pages 1 and 2 of Registration Form
and send with payment to:
Colorado Funeral Directors Association
P O Box 631664
Highlands Ranch, CO 80163-1664 USA
Fax 303-395-2609
ADVOCATE: A licensed funeral service practitioner or individual who maintains certification through the Colorado Funeral Service Board but is not employed by a CFDA or WyFDA Member Establishment; OR an employee of an NFDA Member Funeral Establishment; OR a vendor/supplier representative who is a CFDA Allied/Supporting Member.*
NON-MEMBER: A funeral service practitioner or employee of a Funeral Establishment who is not a Member of CFDA, WyFDA or NFDA; OR a vendor/supplier representative who is not a CFDA Allied/Supporting Member.*
*Non-exhibiting suppliers and vendor representatives are prohibited from marketing and sales activities at the Combined Convention.
All participants are subject to CFDA’s registration terms, cancellation and refund policies (refer to brochure or website for details). CFDA reserves the right to photograph/audio/video at the 2017 Combined Convention, without the expressed written permission of those included within the photograph/audio/video. CFDA may use the photograph/audio/video in publications or other media produced, used or contracted by CFDA, including but not limited to: brochures, email bulletins, websites, social media, etc.
11/17/2018 11:39 AM
Refer the Registrant Names & RSVP section on Page 1
to calculate registration fees. / Number of Registrants / MEMBER / ADVOCATE / NON-
MEMBER / ADD AFTER
JUNE 30 / Total Amount Due
Full Convention Options Registration includes general and breakout sessions, materials, exhibits, Friday reception, Saturday buffet lunch, and Sunday roundtable discussions. Discounts are available when you add Pre-Convention Workshops.
A.Full Convention / $350 / $425 / $499 / +$50 / $
B.Full Convention + Thursday(G) Pre-Convention Workshop Discounted! / $480 / $615 / $759 / +$50 / $
C.Full Convention + Friday (H) Pre-Convention Workshop Discounted! / $430 / $555 / $719 / +$50 / $
D.Full Convention + Both Pre-Convention Workshops (G & H) Discounted! / $550 / $715 / $979 / +$50 / $
One-Day Admissions  Registration includes daily education sessions, materials, exhibits, and reception or lunch. Pre-Con Workshops sold separately.
E.Friday Registration, July 21 – 1PM to 6:30 PM / $150 / $195 / $299 / +$50 / $
F.Saturday Registration, July 22 – 8AM to 3:30PM / $220 / $275 / $399 / +$50 / $
Pre-Convention Workshops Registration includes half-day workshop, materials and beverage break.Lunch not included. Class sizes are limited.
G.“You Only Have One Chance” – Thursday, July 20, 1PM to 5:30PM / $150 / $195 / $269 / +$50 / $
H.“The 4P’s to Avoid Cremation Litigation” – Friday, July 21, 8:30AM to 12PM / $100 / $145 / $229 / +$50 / $
Optional Tickets Saturday, July 22, 6:10PM at Coors Field. Colorado Rockies v. Pittsburgh Pirates. Seating in CFDA reserved section plus concession credit.
I.Take Me Out to the Ballgame – Tickets sold until Friday, July 7. / $52 / $52 / $52 / N/A / $
Limited AdmissionsNo CE or meals.Limited admission provides2-houraccess to Exhibits and refreshments on Friday between 1PM and 6:30PM ORon Saturday between 8AM and 12PM. All guests must check-in at the Registration Desk and wear name tags for admission to Convention and Exhibit activities.
J.Funeral Service Practitioner or Vendor/Supplier Representative No education sessions / $90 / $105 / $179 / +$50 / $
K.Spouse, Partner or Guest Must accompany a Convention registrant / $50 / $65 / $79 / +$50 / $
Payment Method ☐Check payable to CFDA ☐Credit Card Promo code_____
The Colorado Funeral Directors Association is a501(c)6 organization, tax ID# 84-0454478. / TOTAL AMOUNT DUE / $
Cardholder Name / Card number / Exp / CV / Signature

Complete both Pages 1 and 2 of Registration Form and send with payment to CFDA.

Questions? Contact the CFDA Office  Phone 303-791-2336  Fax 303-395-2609  