Attendee Registration - Public Defender Las Vegas Retreat

=============================================================================================

Attendee Registration Form
10th Annual Public Defender Las Vegas Retreat April 23-25, 2010

For each attendee,
print out this page, fill it in, and mail to:
Dave Rendahl, Deputy Public Defender
Tulare County Public Defender's Office
County Civic Ctr, Rm G35
Visalia CA 93291 USA

Please make check or money order payable to Dave Rendahl / Public Defender Retreat. Or FAX this page to 1-559-733-6113.
Or copy and paste this page into an email, fill it in (replace underlines
with your answers), and send to Dave@PublicDefenderRetreat.com.
(If you register by email, you may submit your credit card information by phone, FAX, or snail mail.)

Name: __________________________________________ Title / Office: ___________________________________

Address: ________________________________________ Email Address: __________________________________

City: __________________________ State: ____ Zip: ________ State Bar or Prof. # (optional): ________________

Phone: _________________________ Cell Phone: _______________________ Fax: ________________________

Register before February 28 to win a GPS provided by the Las Vegas Convention & Visitors Authority!

Description	Cost Ea	Qty	Total
Retreat Attendee Registration Fee: $100 before Feb. 28, $120 after Feb 28, or $140 at the Door . . . . . . . . . . . . . . . . . .	. . . . . . .	One Attendee per Form	$_______
Friday Night Improv Comedy Show: 10:30pm show at Harrah's. Ticket price includes taxes and fees.	$28	______	$_______
Saturday Evening World Defender Poker Tournament: 5pm at Tuscany. Print name(s) of Poker Entrant(s) below, use extra sheet if needed: _______________________________________________________________	$65	______	$_______
Saturday Night Music & Dancing with a View: 10pm in the VooDoo Lounge on the 51st floor of the Rio Hotel with an indoor / outdoor patio view of "The Strip." Price includes no wait in line, cover charge, VIP seating, and some free drinks. Meet at VooDoo entrance on 2nd floor of Masquerade Village.	Women $75 Men $85	______ ______	$_______ $_______
Total Payment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . .	. . . . .	$_______

I am Paying by Check: [ ] Money Order: [ ] or Charge To: Visa: [ ] MasterCard: [ ] AmEx: [ ]

Name on Card: _____________________________________ Signature: ___________________________________

Card Billing Address: _____________________________________________________________________________

Card Number: ____________________________________________________ Expiration Date: _________________

=============================================================================================

Retreat Activities:   (You're not committed, but to help us with planning.)

I Plan to Stay at Tuscany Suites: [ ]   Or Other Hotel: ___________________________________________________

Friday Welcome Party 4pm to 7pm at Tuscany Suites (FREE): How Many Attending:  _____ Or If Not Attending: [ ]

=============================================================================================

* The Tulare County Public Defender certifies that this activity has been approved for MCLE credit by the State Bar of California
in the amount of 10 hrs with 1 of the hours in ethics. Tulare County Public Defender is a State Bar of California MCLE approved
provider. We routinely get CLE pre-approval in a number of states, and I will assist any attendee with CLE credit in their jurisdictions.
Contact Dave at his office 559-636-4500, cell 559-303-4377, or Email for MCLE/CLE info on your state or jurisdiction.

=============================================================================================