CANADIAN ROOFING CONTRACTORS' ASSOCIATION

REGISTRATION FORM

45th Annual Meeting and National Conference
Delta Brunswick Hotel
Saint John, New Brunswick May 1 - 4, 2004
(Deadline for Hotel Reservations is April 2nd, 2004)
PLEASE COMPLETE AND RETURN WITH YOUR PAYMENT TO
Canadian Roofing Contractors' Association
2430 Don Reid Drive, Suite 100, Ottawa, ON K1H 1E1
Tel: (613) 232-6724 / (800) 461-2722 Fax: (613) 232-2893
One form per registrant.
Please duplicate this form for additional registrants.

DELEGATE INFORMATION (Please print clearly)

Company Name: ________________________________________________________

First Name: ____________________  Nickname (for badge):______________________

Surname: ______________________________________________________________

Address: ______________________________________________________________

City/Province/P.Code: ____________________________________________________

Phone#: ____________________ Fax#: ______________________

E-mail address: _______________________________

PARTNER Nickname (for badge): __________________________________________

Surname: _____________________________________________________________

IS THIS THE FIRST CRCA CONFERENCE YOU ATTEND?
Delegate   Yes (    )  No (    )        Partner   Yes (    )  No (    )

In order to better plan the functions which are included in your registration fee, please indicate your participation in the following activities we have planned.  Please CIRCLE your answer for each activity.

ACTIVITIES                                                                                                 Delegate                Spouse
Saturday, May 1st         Maritime Kitchen Party                                          YES  NO              YES  NO
Sunday, May 2nd          GOLF                                                                   YES  NO              YES  NO
                                     Bus Tour                                                               YES  NO              YES   NO
                                     Dinner Theatre                                                       YES  NO              YES  NO
Monday, May 3rd         Annual Luncheon                                                   YES  NO              YES  NO
                                     Spouses Bus Tour                                                                               YES  NO
                                     Dinner at Hotel with entertainment                          YES  NO               YES  NO
Tuesday, May 4th          Farewell Breakfast                                                 YES  NO              YES  NO

REGISTRATION FEES                                 Second & each additional delegate/partner  
                                                                           from same company before April 2nd, 2004
Member (Delegate)             $500.00                    $475.00
Member (Partner)               $250.00                    $225.00
Non Member (Delegate)     $600.00                          -
Non Member (Partner)       $300.00                          -

 ** Social Functions (Prices available on site) **

METHOD OF PAYMENT (Circle one)   Check   Visa   MasterCard    AMEX   Bill me (members only)

Credit Card #:_____________________________________________ Expiry Date: _______________

Signature:___________________________________________________ 

(      ) Please check here if you have special dietary or accessibility needs.

Registration Fee (delegate): $ _______________

Registration Fee (partner):   $ _______________

Add GST or HST:              $ _______________

TOTAL REMITTANCE:   $ _______________

** CRCA GST/HST REGISTRATION NUMBER: 106 866 510RT **

CANCELLATION POLICY Cancellation received by April 16th, 2004 entitles the registrant to100 percent refund. Cancellations received after that date will be refunded 80 percent. All refunds will be processed after the Conference. No refunds will be made unless the written refund request is received before April 30th , 2004.