Exhibitor Registration Form

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EXHIBITOR AND SPONSORSHIP OPPORTUNITIES
We would like to extend an invitation for you to showcase your organization and its products and services
at one of our upcoming events. NAFA is dedicated to formalized continuing education for the anesthesia
provider. NAFA is a leader in Patient Safety and continues to be known for its Quality, Value and Service
offered to attendees.
By partnering with NAFA, you will have the opportunity to meet practicing nurse anesthetists from
around the country, many of whom own their own anesthesia businesses or serve in decision-making
roles. They attend our events looking for the most up-to-date information, educational enrichment, job
opportunities and quality products and equipment that are currently available.
Benefits of Exhibiting & Supporting
NAFA is a nationally accredited continuing education association attended by Certified Registered
Nurse Anesthetists (CRNA), Student Registered Nurse Anesthetists, and Anesthesiologists. As an
exhibitor, you will have the opportunity to showcase your organization’s products and services to the
most influential health care practitioners. Here are just a few benefits exhibiting offers:
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Interact face-to-face with influential decision makers
Build visibility for your company in a competitive marketplace
Increase product sales by generating qualified leads
Strengthen existing customer relationships
Introduce new products and services
Conduct market research
What every exhibitor/sponsor fee includes:
One 6’ exhibit table, skirted and draped, chairs and wastebasket
Your organization’s logo and contact information featured in the conference program
Your organization’s logo featured on our conference website, linked to your website
Complimentary conference registration and materials
Nurse Anesthesiology Faculty Associates
P.O. Box 980226
Richmond, VA 23298
Phone: (804) 828-6734
Fax: (804) 828-0581
E-mail: nafa@vcu.edu
www.nafa-va.org
Tax ID # 54-6001758
Company Name:
Street Address/P.O. Box:
City, State, Zip Code:
Work Telephone Number:
Fax Number:
Contact Person:
Title:
Email Address:
Representatives Attending Conference:
Name
Title
1.
2.
3.
Check the meeting(s) for which you wish to register:
29th Annual Anesthesia Seminar in Hilton Head, South Carolina (May 27 – 30, 2015)
 1 Exhibitor table only: $500
 1 Exhibitor Table w/Electricity
 2 Exhibitor tables w/Electricity: $900
 Sponsor a Breakfast:
 Sponsor a Reception: $4,000
 Sponsor a Break:
 Other: __________________________
$550
$2,500
$1,500
39th Annual Anesthesia Conference in Williamsburg, Virginia (November 2 - 5, 2015)
 1 Exhibitor table only: $500
 1 Exhibitor Table w/Electricity
 2 Exhibitor tables w/Electricity: $900
 Sponsor a Breakfast:
 Sponsor a Reception: $4,000
 Sponsor a Break:
 Other: __________________________
$550
$2,500
$1,500
34th Annual Anesthesia Meeting at Walt Disney World, Florida (November 30 - December 3, 2015)
 1 Exhibitor table only: $500
 1 Exhibitor Table w/Electricity
 2 Exhibitor tables w/Electricity: $900
 Sponsor a Breakfast:
 Sponsor a Reception: $4,000
 Sponsor a Break:
 Other: __________________________
$550
$2,500
$1,500
Please choose your payment method:
 Check enclosed (Please make check payable to Nurse Anesthesiology Faculty Associates.)
Credit Card:
Visa
 Mastercard
 Discover
 American Express
Card Number ____________________________________________ Expiration Date ____________________
Verification code (3- or 4-digit number on back of card) __________ Signature _________________________
TERMS & CONDITIONS
The Nurse Anesthesiology Faculty Associates (“NAFA”), Host Facility, their officers, directors, agents and employees are
not responsible for the safekeeping of personal belongings, equipment, laptop computers, displays, supplies, materials or any
other valuable item(s) left in meeting rooms, conference areas or exhibit areas of the Host Facility during NAFA’s events.
Please be cautioned that these areas are considered public areas of the Host Facility and as such, neither NAFA nor the Host
Facility can be held liable for the theft, loss or damage to any property left in these areas. Exhibitors who wish to insure their
exhibit materials, goods and/or wares against theft, damage by fire, accident or loss of any kind, must do so at their own
expense
Exhibitors may provide their own equipment or furnishings. Individual charges for equipment and utilities will be
made by the Host Facility, and must be negotiated with the facility or the agent for these services. All utility needs are
to be paid by the exhibitor as outlined on the exhibitor registration form. The exhibit hall aisles and booths will be carpeted.
In the event of failure or inability to fulfill this contract, or to furnish the space, due to fire, strikes, authority of the law,
act of God, acts of terrorism, or any other cause or reason, NAFA agrees to return to the exhibitor all deposits or other monies
paid, and thereupon this agreement shall be deemed canceled by mutual consent, and NAFA shall be relieved of all
responsibility.
The exhibitor agrees to protect, save and keep NAFA, the Host Facility, its owners, its operator, and each of their respective
parents, subsidiaries, affiliates, employees, officers, directors, and agents forever harmless from any damage or charges
imposed for violation of any law or ordinance by the exhibitor or his employees or agents, as well as to strictly comply with the
applicable terms and conditions contained in the agreement between NAFA and the Host Facility regarding the exhibition
premises. Further, exhibitors shall at all times protect, indemnify, save and keep harmless NAFA, the Host Facility, its owners,
its operator, and each of their respective parents, subsidiaries, affiliates, employees, officers, directors, and agents against
and from any and all loss, cost, damage, liability or expense which arises out of or from or by reason of any act or omission of
the exhibitor, his employees or agents.
Exhibitor should maintain general public liability insurance in any amount sufficient to cover such obligations, including show
cancellation insurance. Exhibitor acknowledges and agrees that it will obtain, at its own expense, any and all licenses or
permits in order to comply with all local, state and federal laws, ordinances and regulations for any of its activities in connection
with any NAFA events.
In compliance with the Americans with Disabilities Act of 1990, Nurse Anesthesiology Faculty Associates will make all
reasonable efforts to accommodate persons with disabilities at each of its events. Please call 804-828-6734 with your request.
RULES GOVERNING EXHIBITS
Infraction of rules on the part of an exhibitor or its representatives, or both, will subject the exhibitor or its representatives to
dismissal from the exhibition hall and dismantling of the exhibit, in which event it is agreed that no refund shall be made by
Nurse Anesthesiology Faculty Associates (NAFA) and, further, that no demand for redress will be made by the exhibitor or
his/her representatives.
1.Exhibits which have a disruptive nature and/or unsuitable content, as determined solely NAFA are not permitted.
2. Live or recorded music attractions used in an exhibit must have prior written approval from NAFA. Requests should be
submitted to the meeting coordinator. Exhibitor must obtain its own license for copyrighted music used in the exhibit space
and will indemnify and defend NAFA against any claims or suit alleging copyright infringement for the use of music by the
exhibitor.
3. Advertising material or signs of firms other than those that have rented booth space are prohibited. Canvassing and
solicitations of business, except by exhibiting firms, are prohibited.
4. NAFA events include accredited CME activities, which are governed by the American Association of Nurse Anesthetists.
In accordance with these Standards, NAFA has established the following policies for commercial exhibits held in conjunction
with its educational activities:
a) Arrangements for exhibits may neither influence, planning or interfere with the presentation of the
educational activity.
b) Commercial/promotional materials may not be displayed or distributed in the same room immediately
before, during, or immediately after the CME activity.
c) Representatives of commercial supporters and exhibitors may attend the CME activity if they wish, but
may not engage in sales activity in the room where the educational activity is held.
d) Exhibitor is required to disclose via signage at the exhibit booth, FDA status of the medical devices or
pharmaceuticals displayed.
5. NAFA events are non-smoking meetings. No smoking is permitted in the meeting rooms or exhibit areas.
6. There will be no subletting of space or use of a booth by two or more firms except by written permission of NAFA.
7. The Host Facility may impose other rules on the exhibitor, and the exhibitor agrees to abide by the Host Facility’s rules.
In the event of a conflict between these rules and those imposed by the Host Facility, the Host Facility’s rules will control.
8. Use of Function Space: To protect the safety and security of all Host Facility guests and property, the Exhibitor agrees that
it will not use any items in the function space that create any amplified noise, smell, or visual effect other than decorations
without advance notification and written approval by the Host Facility. Examples of items that require advance approval
include, but are not limited to: smoke or fog machines, dry ice, confetti cannons, candles, incense, or any other activity that
generates smells. Exhibitor will obtain any required Fire Marshall or other safety approvals, and agrees to pay any expenses
incurred by Host Facility as a result of such activity, such as resetting smoke or fire alarms or unusual clean up costs.
The undersigned acknowledges receipt of and agrees to abide by the attached Rules Governing Exhibits, which rules are
considered to be part of the agreement between exhibitor and Nurse Anesthesiology Faculty Associates (NAFA).
SIGNATURE: _____________________________________________________ DATE: __________________________________
TITLE: _______________________________________________ COMPANY: _________________________________________
PLEASE RETURN THIS AGREEMENT TO:
Nurse Anesthesiology Faculty Associates
P.O. Box 980226
Richmond, VA 23298
Phone: (804) 828-6734
Fax: (804) 828-0581
E-mail: nafa@vcu.edu
www.nafa-va.org
Tax ID # 54-6001758
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