Exhibit Registration

Please type or print
Company*
Contact*
First Last
Title
Phone*
Fax
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Website
Email Address*
Product to be Displayed

Exhibit Hall Layout
Booth Selection
Use the exhibit hall floor plan to determine booth size and location. Please indicate four booth selections, so we may process your application as close to your request as possible. No booth space will be reserved unless accompanied by payment. Booth reservations will not be taken by phone.
Booth Preference*
Selection 1 Selection 2 Selection 3 Selection 4
Please list any companies you do not wish to be placed next to
Booth Identification (2 lines only)
ONLY ONE COMPANY NAME PER BOOTH WILL BE LISTED ON THE BOOTH SIGNS. If more than one company name is submitted, only the first name will be used.
Company*
City / State
City State
Badges
Three badges are distributed to each exhibiting company. Additional badges may be purchased for a registration fee of $35. Please list names for badges.
Badge Name #1
Badge Name #2
Badge Name #3
Additional Badges
Payment Method*
- Check
- Credit Card

Consent*
In accordance with the Contract Regulations governing the exhibits to be held at Central Bank Center, April 19-20, 2024, the undersigned accepts and agrees to all terms and hereby makes application to exhibit. Upon application, this document constitutes a formal contract.
Terms & Regulations
Number of Booths ($1,000 each):
Number of Additional Badges ($35 each):
*Registration comes with 3 badges

Terms & Regulations
Payment
Registration includes three name badges (per exhibitor), your company name in the program and all the meal functions in the exhibit hall. Please make your check payable to the Kentucky Optometric Association, P.O. Box 572, Frankfort, KY 40602.
Consent*
In accordance with the Contract Regulations governing the exhibits to be held at Central Bank Center, April 19-20, 2024, the undersigned accepts and agrees to all terms and hereby makes application to exhibit. Upon application, this document constitutes a formal contract.
Number of Booths ($1,000 each):
Number of Additional Badges ($35 each): Quantity
*Registration comes with 3 badges
Price: $35.00
Total
$0.00
Credit Card
Card Details
Cardholder Name

Booth Selection