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Workers Compensation professionals - working together for best results!

2021 WORKERS' COMPENSATION CONFERENCE

Program
Highlights

Conference
Schedule

Registration

Continuing
Education

Hotel & Other
Information

Conference
Events

Attendee Registration

You May Pay by Credit Card or Check

Complete and submit this secure, online registration form with your credit card payment, to immediately secure your place at the 2021 Worker's Compensation Conference.
Or click <<HERE>> for a downloadable PDF of the Registration Form.
**If mailing a check payment, you must still submit this registration form. An invoice will be automatically emailed to you after submittal. Please mail payment within 5 days of registering online. Include your payment, your Order Number in memo field, and a copy of your emailed invoice. Mail to:

MWCEA, Inc.
1750 K Street NW, Suite 700
Washington, DC 20006
ID # 52-1353216

2021 REGISTRATION FEES (Per Person Rates)
	By 7/31/2021	After 7/31/2021
Individual	$275	$325
4 Or More*	$250	$250
Companion**	$175	$225

* 4 or more registered at the same time will pay one at full price ($275 by 7/31; $325 after 7/31), then $250 for each additional attendee.

** Only ONE Companion allowed per registrant. Companions are persons who accompany the registered individual for personal reasons as distinguished from someone with a professional interest in workers' compensation. Companion registration includes social events only. (Companions are not allowed to attend the trade show exhibits or CE sessions and will be issued GUEST Badges that must be worn at all times.)

4% Service fee charges will be added to credit card payments. These are calculated by credit card companies based on transaction amounts and are not collected by the MWCEA.

Print Deadline: All registrations, sponsorships, exhibitor, advertising, contributions and artwork must be postmarked or submitted, and paid, by August 15, 2021 to guarantee placement in the MWCEA Conference Book.

- NO REFUNDS -

Please complete as much of the following form as possible.
BUSINESS CONTACT INFORMATION ONLY
Contact information submitted will be printed in Attendee Directory.

(Mandatory information is labeled in red)

Name
(as printed on badge):

Company:

Title:

Industry:

Office Information

Address:

City:

State:

Zip:

Phone:

Fax:

Email:

Additional Information

Do you plan to register onsite for CEU?

CCM

CDMS

CRC

CLE Letter of Attendance

Are you an Exhibitor?

Yes

What format do you wish to receive Conference Materials in?

Hard Copy Book

Electronic

* A $25 Conference Book Charge will apply on-site if you select electronic format now, then want a hard copy at the conference.

Registration

Please indicate how many people will be registering:

Yourself:

1 @

Additional Registrants:

(10 maximum)
1 to 3 (including Yourself) @ $275.00 each.
For 4 or more, all Additional Registrants are @ $250.00 each.

Companion:

Companion's Name
(on badge):

I understand that the companion registration does NOT include access to the booths, trade show, CE sessions or Lunch & Learn. Access is to Social Events ONLY. Companions will be issued GUEST Badges that must be worn at all times. (Please check box to signify you have read and understand.)

The early bird rate $275 is only good if registration is PAID for and received by July 31, 2021. If paying by check, please register by July 20. Afterwards, payment MUST be received by MWCEA within 10 days of registration. All registrations not paid by July 31 will automatically be increased to the regular conference rate $325.

Additional Registrant Details

#	First Name	Title	Industry
1.
	Office Phone:	Office Email:	Conference Materials: Hard Copy Book Electronic
2.
	Office Phone:	Office Email:	Conference Materials: Hard Copy Book Electronic
3.
	Office Phone:	Office Email:	Conference Materials: Hard Copy Book Electronic
4.
	Office Phone:	Office Email:	Conference Materials: Hard Copy Book Electronic
5.
	Office Phone:	Office Email:	Conference Materials: Hard Copy Book Electronic
6.
	Office Phone:	Office Email:	Conference Materials: Hard Copy Book Electronic
7.
	Office Phone:	Office Email:	Conference Materials: Hard Copy Book Electronic
8.
	Office Phone:	Office Email:	Conference Materials: Hard Copy Book Electronic
9.
	Office Phone:	Office Email:	Conference Materials: Hard Copy Book Electronic
10.
	Office Phone:	Office Email:	Conference Materials: Hard Copy Book Electronic

* A $25 Conference Book Charge will apply on-site if you select electronic format now, then want a hard copy at the conference.

Additional Registration Options

Yes! Please RSVP me for the Lunch & Learn Session on Monday:

Yes! Please RSVP me for the Lunch & Learn Session on Tuesday:

Yes! Please RSVP me for the Raffle Drawing on Wednesday:

TOTAL AMOUNT DUE:

All discounted registrations must be from the same entity, combined and submitted at the same time.

By completing and submitting the MWCEA registration form, you are agreeing that you have read, understand and agree to the stated release / waiver statement as follows:

The current worldwide coronavirus (COVID-19) pandemic and associated government-mandated orders underscore the risks associated for individuals attending public events, including the MWCEA Conference. I / we agree to comply with all government orders and I / we understand that personal contact with others may occur and my / our attendance involves a certain degree of risk that could result in illness, permanent disability, or death. I / we have been provided the latest recommendations from the CDC and I / we hereby release and hold harmless the Maryland Workers Compensation Educational Association from any liability of any kind whatsoever, including injury or death claims, arising or allegedly arising from my / our attendance at the MWCEA Conference, regardless of the theory of recovery asserted, including, but not limited to claims based on allegations of negligence. I / we intend this release to be the broadest release allowed by law.

Refund Policy

No Refunds will be granted. Registration fees are transferrable.

Payment Policy

The acceptable methods of payment are checks, cashier's checks, money orders or credit card. All payments must be made by August 15, 2021 to be included in the MWCEA Annual Program Directory. All early bird fees must be paid prior to July 31, 2021 or will automatically increase to the regular attendee registration fee.

Cancellation Policy

All cancellations MUST be submitted in writing (emailed to info@mwcea.com). Telephone requests WILL NOT be honored. Paid registration (attendee or exhibitor) fees will be transferred or credited. The registrant will be held responsible for any unpaid registration fees, regardless if they do not attend the conference.