NIRSA 2015 Registration Form PDF

“Moving Our Values Forward” O 66th NIRSA Annual Conference & Rec Sports Expo O March 30-April 2, 2015 O Grapevine, Texas
Register online
About You
Last Name First Name (as you would like it to appear on your badge)
Title Fax this form with credit card info
Institution / Installation / Agency Business Mailing Address City State / Province Zip Mail this form with payment:
Work Phone Cell Phone NIRSA Headquarters
4185 SW Research Way
Corvallis, OR 97333-1067
Email o It’s okay to share my email address with vendors who are exhibiting at the 2015 Expo
† † Disability Services Requested
o Visual o Hearing o Physical o Accompanying Personal Care Assistant o Other:
Orders submitted by fax or mail will take 2-3 business days to process and will be handled on a
first-come, first-served basis.
Call NIRSA Headquarters Monday-Friday, 8:00am5:00pm Pacific, toll-free 877-874-7735
Get updates via email
NIRSA sends updates about the Annual Conference
as a benefit to all members who wish to receive
them. Make sure you receive vital information ahead
of the curve by adding your email address to our
database. Edit your profile at to
ensure NIRSA has a valid email address. Please
contact [email protected] for assistance.
Email addresses will be used for official NIRSA business only, and will not be sold to outside parties.
Volunteering is a great way to network! If you are
interested in volunteering during the Conference,
email [email protected]
If you choose any of the above options a NIRSA representative will contact you to follow up regarding your request.
Registration Prices
Early Bird
After Feb 18, 2015
On/Before Feb 18, 2015
Professional Member from Member Institution / Life Member
■■ $485
❍❍ $555
Professional Member
■■ $565
❍❍ $635
Professional Nonmember from Member Institution
■■ $620
❍❍ $690
Professional Nonmember
■■ $735
❍❍ $805
Student Member from Member Institution
■■ $365
❍❍ $435
Student Member
■■ $450
❍❍ $520
Student Nonmember from Member Institution
■■ $430
❍❍ $500
Student Nonmember
■■ $525
❍❍ $595
Associate Member (not exhibiting)
■■ $720
❍❍ $790
Associate Nonmember (not exhibiting)
■■ $1,245
❍❍ $1,315
Retired / Emeritus
■■ $195
❍❍ $265
Tuesday, March 31
■■ $360
†† $430
Wednesday, April 1
■■ $360
†† $430
Thursday, April 2
■■ $360
†† $430
One-Day Only
Member Only)
* The term “member” refers to those with a current NIRSA membership both at the time of registration AND throughout the Conference.
Nonmember registration rates include a complimentary one-year student or professional NIRSA membership. If you are unsure about your
individual membership status or your institution’s membership status, please send an email to [email protected]
Bring Your Boss!
Individuals not employed in recreation departments, to whom NIRSA recreation professionals report,
may register at the same professional rate as a registered Annual Conference attendee. Submit your
boss’ information below and the rate of your Annual Conference registration, and your supervisor,
VP or President can attend at the corresponding professional rate. By attending the NIRSA Annual
Conference & Recreational Sports Expo, your boss will gain insight into the contributions you and
recreation make in the areas of recruitment, retention, and overall satisfaction at your institution.
Boss’ Name Boss’ Email Boss’ Title Your Annual
registration rate:
Policies & Information
Payment is accepted via credit card, check, or money order.
If paying by credit card, payment is due with the registration
form. You may include a purchase order number on your
registration form to indicate a forthcoming check; however, a
purchase order is not considered payment and no purchase
orders will be accepted after February 18, 2015.
Preconference Events
You must be a conference registrant to attend
these Preconference Events.
Early Bird
On/Before Feb 18, 2015
After Feb 18, 2015
*Trip — Trinity River Paddle
*Facilities Tour — Dallas Area
*Facilities Tour — Fort Worth Area
In order to qualify for the early bird discount, your check or
money order must be postmarked no later than February 18,
2015. They must be payable to “NIRSA,” and foreign checks
must be imprinted “US Funds.”
*Workshop — J. Michael Dunn Student Professional Development Workshop
Workshop — Articulating the Value of Campus Recreation
■■ $45
❍❍ $45
Workshop — Creating a Culture of Evidence for Health & Wellbeing
■■ $60
❍❍ $60
You will be emailed a receipt and an email confirmation, which
will include a personal link to the hotel reservation system,
within 15 days of receipt of your registration at NIRSA Headquarters. An email address is required to receive a receipt/
confirmation of registration. If you do not receive an email,
please contact NIRSA HQ at 541-766-8211.
*Workshop — Developing a Comprehensive Officials Training Program
■■ $80
❍❍ $80
*Workshop — Engaging Social Justice: From Awareness to Action
■■ $78
❍❍ $78
*Workshop — ACE Small Group Training
■■ $159
❍❍ $159
Community Service Project
■■ $25
❍❍ $25
Refund policy for conference registration cancellations
T-shirt Size (for Community Service Project) m S m M m L m XL m XXL
All conference cancellations and refund requests must be
made in writing and mailed, faxed, or emailed to:
* These events have maximum capacities.
NIRSA Conference Refund
4185 SW Research Way
Corvallis, OR 97333-1067
Fax: 541-766-8284
Email: [email protected]
Refund requests are processed according to the following
time restrictions:
• Refund requests received on or before February 18,
2015 will receive a 100% refund
• Refund requests received on or between February
19 and March 13, 2015 will receive a 50% refund
• Refunds cannot be guaranteed for requests received
on or after March 13, 2015, or for no-shows at the
Extenuating circumstances may warrant exceptions to the
refund policy. For a review of a specific refund amount or for
more information about refund requests, please contact Megan
Granholm, NIRSA’s Billing Coordinator, in writing.
Cancellation policy for preconference events
If an Annual Conference preconference event doesn’t receive a
minimum number of required pre-registrants, the event may be
cancelled. If this occurs, NIRSA offers either a full refund of the
preconference registration fee, or the fee can be applied toward
another preconference event at the same Annual Conference
or toward registration fees for another NIRSA education event.
Career Opportunities Center
Employers: Register at; select “Career Fair Registration”
Non-smoking policy
For the comfort and health of attendees, smoking is not permitted at any NIRSA function. This includes general sessions,
educational sessions, workshops, socials, and the Recreational
Sports Exposition.
Responsibility code
Recognizing that many people will take advantage of the
opportunity for socializing and alcohol consumption, the
Board of Directors, and the NIRSA Conference Program and
Conference Host Committees actively encourage responsible
decision-making and healthy choices. Supporting this policy,
non-alcoholic beverages will be offered at all NIRSA-sponsored
receptions. In accordance with Texas State Law, no alcohol will
be served to anyone under age 21.
What to wear
Suggested conference attire is business casual. This includes
khaki slacks, polo-type shirts, blazers, or sweaters. Attire for
the Honor Award Banquet is semiformal.
See pricing at
If you have any questions, contact Kendra Hall at [email protected]
Other Events
Guest/Spouse Program.
Please note: The Guest Program is now closed.
If you have questions, please contact NIRSA.
■■ $199
■■ $199
Mark Fletcher Fun Run — Professional or Spirit Sprinter
■■ $25
❍❍ $25
Mark Fletcher Fun Run — Student
■■ $15
❍❍ $15
Honor Award Banquet EXTRA TICKET
Main registration includes the Honor Award Banquet. Choose this option only if you are
bringing a guest who isn’t already registered for the Guest/Spouse Program.
■■ $90
†† $90
All Conference Social EXTRA TICKET
Main registration includes the All Conference Social. Choose this option only if you
are bringing a guest.
■■ $45
†† $45
T-shirt Size (for Fun Run) m S m M m L m XL m XXL
New! — I plan to use the following:
Photograph content ownership
NIRSA will use photographs taken during the 2015 NIRSA Annual Conference & Recreational Sports Exposition to promote
the Association and future events. Your registration form
provides NIRSA with the unrestricted right to use photographs
at its discretion for the purpose outlined above.
FREE for Candidates
Candidates: The COC is free to student and professional candidates
m Conference smartphone app m Printed conference program m Both app and program
o I would like to use a presenter voucher/coupon for this event.
Voucher/Coupon # TOTAL Voucher/Coupon Amount $ Balance must be paid in full before registration can be processed.
m Visa m MasterCard m Discover m American Express m PO#/Check# ________________
Credit Card # Expiration Date Signature o I would like to use a second card for a portion of the total.
Total to be charged to this card: $ _______________
m Visa m MasterCard m Discover m American Express
Credit Card # Signature Expiration Date