2024 Registration 2024 CEO Forum Registration Form HOW TO REGISTER To register, please complete the following form. For a PDF registration form, please email to email@example.com REGISTRANT INFORMATION (one form per registrant) Name* First Name for Badge* Title* Company Name:* Street Address* Street Address 2 City* State* Zip Code* Country*United StatesCanadaOtherPhone*Email* What is the approximate employee count for your firm?*Less than 50 Employees50 - 200 Employees200 - 500 Employees500 - 1,000 EmployeesOver 1,000 EmployeesAre you registering on someone's behalf? Yes No If yes, please include your name and email below to receive confirmation and additional information. Email REGISTRATION FEE Registration fee: $2,995 Covers all meals, events, & gratuity for registrants, including the Sunday Super Bowl Party, Monday night and Tuesday night cocktails/dinner at The Lodge.Will you attend the Super Bowl Party on February 11, 2024. Yes, I will be there. No, I can't make it. Undecided at this time. ACTIVITIES NOT INCLUDED IN REGISTRATION FEE: Golf: Wednesday, February 14 (tee times begin at 9 am) at Torrey Pines South ($350 per player; $75 golf club rental); No refunds will be given for golf cancellations received after January 5, 2024.Guest Package: Includes Sunday, February 11 Super Bowl Party, Monday, February 12 cocktails and dinner at The Lodge at Torrey Pines, and Tuesday, February 13 cocktails and dinner at The Lodge at Torrey Pines ($500)Guest Name 2023 CEO Forum Registration*PAYMENT OPTIONSPayment Options:* CEO Forum Registration Guest Package Wednesday Golf Golf Club Rentals Total Due $0.00 Pay By Check or Credit Card Credit Card Send an Invoice Charge my American ExpressMasterCardVisaSupported Credit Cards: American Express, MasterCard, Visa Credit Card # Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Name on Card HOTEL ROOM RESERVATIONS A|E Advisors has contracted a special group rate at The Lodge at Torrey Pines for $470/night* plus tax for the six nights from Friday, February 9 through Wednesday, February 14. To reserve during that period, visit this link: Group Rate * Subject to availability, the group rate applies only to reservations made before 5PM on Friday, January 12, 2024. To reserve, cancel or change a reservation after January 12, email The Advisors at firstname.lastname@example.org or call 703-760-9120. ONE-ON-ONE SESSIONS WITH A|E ADVISOR CONSULTANTS A|E Advisor Consultants will be available to meet with you, one-on-one. Please select the advisor you would like to meet with.One on One Matt Gough, President & Partner, Ames & Gough, Risk Management Consultant - Professional/Commercial Liability & Employee Benefits Insurance Brett Gough, COO & Partner, Ames & Gough, Risk Management Consultant - Professional/Commercial Liability & Employee Benefits Insurance Rich Friedman, President, Friedman & Partners, Business Planning, Executive Search, Marketing & Biz Dev Strategy/Research/Planning & Client/Prospect Perception Studies Barbara Irwin, Founder & CEO, HR Advisors Group, Leadership Development & HR Strategy Cara Bobchek, Senior Management Consultant, HR Advisors Group, Vision & Purpose Alignment, Strategic Planning, & Organizational Strategy. Colvin Matheson, Managing Director, Matheson Financial Advisors, Business Valuation, M&A, and Ownership Transition. David Cohen, Managing Director Matheson Financial Advisors, Business Valuation, M&A, and Ownership Transition. Kathryn Sprankle, Owner, Sprankle Leadership, Governance Structuring & Organization Design, Board Advisory, & Individual Leadership Counseling. No, thank you - I am not interested in meeting with an advisor at this time. CANCELLATION POLICY If you have to cancel your registration or golf, email email@example.com right away. A|E Advisors will provide a full refund for CEO Forum cancellations received in writing by January 5, 2024. Note: No refunds will be given for golf cancellations received after January 5, 2024. REGISTRATION QUESTIONS Email firstname.lastname@example.org or call Kelly Standiford at 703-760-9120.