2011 Annual Conference
Registration Form

Boston, MA

Attendee Information
First Name: *
 Last Name: *
First name as it should appear on your name tag: *
Title: *
 Company: *
Address: *
 City: *
State: *
 Zip: *
Email: * (please use your email not your assistants)
 Phone: *
Emergency Contact Name:
 Phone:
Is this the first time you are attending an ICE Conference? *
Yes | No 		Bringing a guest? Please enter their name here:
To strengthen our ability to build an effective network among ICE conference attendees, please indicate your area of primary personal discipline (check as many categories that apply):
  • Commercial Lines Agency Bill
  • Commercial Lines Direct Bill
  • Personal Lines Agency Bill
  • Personal Lines Direct Bill
  • Workers Compensation Agency Bill
  • Workers Compensation Direct Bill
  • I am an Agent or Broker
  • I am a Conference Speaker
  • I am a Conference Exhibitor
  • Other
Guided Walking Tour, Monday, 10/24 @ 8:30 AM
A Walk Into History private walking tour is a great way to experience the Freedom Trail. Led by an 18th Century Costumed Guide, the 90-minute tour mixes humor, history and fun. Be transported back in time to the days of the American Revolution and have a hands-on revolutionary experience. You will see 11 of the 16 stops on The Freedom Trail during the guided walking tour.
  • Gather in the hotel lobby at 8:00 AM
  • Meet your 18th Century Costumed guide at the Boston Commons Visitor Center on the west side of Faneuil Hall at 8:30 (a 5 min walk from the water taxi drop off)
  • Tour lasts until 10:00 AM and ends in Faneuil Hall (15 minute walk back to the water taxi at Faneuil Hall)
  • Depart via water taxi from Faneuil Hall pier
  • Arrive back at hotel at approximately 10:30 AM
  • Cost per person $25, this includes a roundtrip water taxi ride from the hotel as well as the guided walking tour
  • Must have at least 13 people register to schedule this event
Please indicate if you plan to join us for the optional Boston walking tour.
Yes | No *
Selecting yes adds $25 to the amount due.
Your non-employee guest is welcome on the walking tour. Guest Attending?
Yes | No *
Selecting yes adds $25 to the amount due.
Kick Off Event Monday at 4:00 PM
Old Town Trolley Tour of Boston
Networking Reception at The Bleacher Bar in Fenway Park
Dinner at Boston's Historic Durgin Park Restaurant
Board an Old Town Trolley with your colleagues just outside the hotel for a 90 minute guided tour of Boston. The trolley drops us off at Fenway Park for our kick off networking event. The tour resumes taking us to Durgin Park restaurant for an outstanding meal. The trolleys return to the hotel after dinner. Links with additional information for: Old Town Trolley, The Bleacher Bar and Durgin Park are available on the ICE Website under Conferences.
Please indicate if you plan to join us for the Kick Off Event.
Yes | No *
Dinner Selection
Please indicate your dinner selection.
Strip Sirloin served with choice of garden salad or New England clam chowder, cornbread, potato, vegetables, beverage and dessert of choice.
Roast Loin of Pork served with choice of garden salad or New England clam chowder, cornbread, potato, vegetables, beverage and dessert of choice.
'Clam Bake' served with clam chowder, steamed clams, lobster, boiled potatoes and corn on the cob, beverage and dessert of choice
Pasta Primavera served with: choice of garden salad or New England clam chowder, cornbread, potato, beverage and dessert of choice
Guest Attending?
Please tell us if your non-employee guest is joining you at the Kick Off Event for both the reception and dinner. This is the only conference event open to guests. Guests must be at least 21 years old.
Guest Attending?
Yes | No *
Selecting yes will add $100 to the amount due.
Please indicate your guest’s entrée selection:
Strip Sirloin served with choice of garden salad or New England clam chowder, cornbread, potato, vegetables, beverage and dessert of choice.
Roast Loin of Pork served with choice of garden salad or New England clam chowder, cornbread, potato, vegetables, beverage and dessert of choice.
'Clam Bake' served with clam chowder, steamed clams, lobster, boiled potatoes and corn on the cob, beverage and dessert of choice
Pasta Primavera served with: choice of garden salad or New England clam chowder, cornbread, potato, beverage and dessert of choice
Dietary Restrictions or any other special needs?
For you?

For your guest?
Premiere Reception and Group Dinner
On Tuesday evening join other conference attendees as we host our annual reception and dinner event. This is always a fun evening.
Please indicate if you plan to join us for the premiere reception & dinner event:
Yes | No *
Grilled Filet of Beef with roasted shallot golden potato puree and brandied Morel sauce
Pistachio crusted Rack of Lamb with braised leeks and olive oil whipped potato
Lemon-chive crusted Georges Bank Cod with champagne-citrus bitter sauce and steamed baby potatoes
Toasted Barley Risotto with exotic mushrooms, caramelized pearl onions with truffle butter
Registration Fees *
Includes: Kick-off events, Tuesday & Wednesday breakfasts, receptions & dinners, and lunch Tuesday. Monday's guided walking tour of Boston is not included.
Member Company, First Registrant $500.00
Member Company, Each Additional Attendee $300.00
Non-Member Company (P&C Carriers only) $800.00
Non-Member Agent/Broker $800.00
Exhibitor (Invitation Only)
Speaker (Invitation Only)
Total Due including guest and walking tour fees if selected.
Registration
Complete this registration form and mail a check (sorry we can't accept credit cards) payable to:
Insurance Collection Executives Attention: Jim Mennen
4509 N. Haymeadow Ave.
Appleton, WI 54913
 
Payment must be received before the conference.
General Information
Hotel Accommodations
Hyatt Harborside
101 Harborside Drive
Boston, MA 02128
(617) 568-6030
Conference Sign-In
All conference attendees must sign-in with ICE to pick up: conference book, ID and dinner tickets. Attendee & Exhibitor sign-in takes place in the Raffaello Room - 2nd Floor during the following hours:
Sunday, October 23 between 4:30-6:00 PM
Monday, October 24 between 10:00–11:00 AM
Name Tags
Please display your ICE name tag throughout the conference as it insures your admittance to all conference events.
Dress
If you are attending the network reception please wear a t-shirt from your favorite baseball team. Let's see if we have every team represented. A warm jacket is recommended for the trolley tour.
Suggested dress for the conference is business casual.
Registration Policy

Your registration fee includes all ICE conference related meals, receptions and associated events. Travel and hotel accommodations and related charges are not included and are your personal responsibility. Please notify us if at any time in advance of the conference you have a need to substitute an attendee. To ensure your inclusion on our conference booklet, we must receive your registration by September 9.

ICE will take pictures during the conference and events. They will be used on the ICE website and ICE promotional material. If you do not want a picture with you in it used by ICE please send an email to: Ken@theicesite.com.
To Cancel Your Registration
If you cancel your registration before September 23, 2011, you will receive a refund less a $100 administration fee. We can not accept any cancellations received after September 23, 2011. Substituting an attendee in your place is always an option and can be done up to the time of the conference. All cancellations and substitutions must be in writing via email to Jim Mennen at jmennen@new.rr.com.
Questions?
Contact Ken Godfrey at (707) 780-8416, or email to ken@theicesite.com.

Once you click on "submit registration" do not use the browser's back button to edit the registration form. You will receive a confirmation and receipt via email. Please only click the submit registration link once.