Bermuda ReUnderwriting Re Building Professional Expertise


March 20-21, 2012, Hamilton, Bermuda Registration: Please print or type


Name _________________________________________________________________________________________ Title _________________________________________________________________________________________ Company/Organisation ___________________________________________________________________________ Address ___________________________________________________________________________________ Town


________________________________ Telephone Payment for:


_______ $ 1295 _______ $ 1350 _______ $ 1250 _______ $ 1200 _______ $ 750


Early Bird Registration before February 10, 2012 General Registration


RAA Association Partners (Includes BII and ABIR Members) RAA Members Regulators


Method of Payment (Payment must accompany registration) Enclosed is a check made payable to Reinsurance Association of America.


Credit card:


Credit card number: Expiration Date:


Name on credit card: / ______________________________________ Authorized Signature: ______________________________________


Venue: The Fairmont Hamilton Princess 76 Pitts Bay Road, Pembroke HM 11, Bermuda Tel: (441) 295-3000


For sponsorship E-mail: hamilton@fairmont.com


Cancellation: If you are unable to attend, a substitute delegate is welcome at no extra charge. Refunds will be made for cancellations received in writing no later than Tuesday, March 6, 2012. Thereafter we regret that no refunds can be made.


opportunities or exhibiting contact Ann Marie Mwombela +1.202.783.8385


mwombela@reinsurance.org


Mail or fax this form to: Johnetta Riley, Reinsurance Association of America, 1445 New York Avenue NW, 7th Floor, Washington DC 20005, USA; fax +1 202.638.0936; or email riley@reinsurance.org.


For more information contact Johnetta Riley or go to www.reinsurance.org. Or go online to register at www.reinsurance.org. Master Card VISA Country _____________________________________


_________________ Email


Post Code ___________________ _____________________________________________


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