2025 Fall Convention Exhibitor Form CHCA 2025 Fall Convention Exhibitor Information Organization Name(Required)Organization Logo(Required)Max. file size: 21 MB.Business Type(Required)Organization Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Organization Phone Number(Required)Phone ExtensionHow many booths will your organization need for the Convention?(Required)Preferred Booth Location (Two Options)(Required)Any End Cap Booths will require an additional $100 fee.Additional Booth AmenitiesWill your organization require electricity at your booth?(Required) No Please note there is an additional fee for this service. Please list any competitors you do not want your booth near:Please list any (two) companies you would prefer for your booth to be near:First Representative Name(Required) First Last This Representative should be the primary contact. First Representative Title(Required)First Representatives Email(Required) First Representatives Phone Number(Required)Please note, if the organization has already used their platinum booth for 2024; CHCA will reach out to the First Representative for Payment. Fall Conference Events Wednesday Lunch ($35 Fee) Thursday Lunch ($35 Fee) Spotlight on Excellence ($75 Fee) Representative One will attend the following EventsSecond Representative Name First Last Second Representative TitleSecond Representatives Email Second Representatives Phone NumberFall Conference Events Wednesday Lunch ($35 Fee) Thursday Lunch ($35 Fee) Spotlight on Excellence ($75 Fee) Representative Two will attend the following EventsThird Representative Name First Last Third Representative TitleThird Representatives Email Third Representatives Phone NumberFall Conference Events Wednesday Lunch ($35 Fee) Thursday Lunch ($35 Fee) Spotlight on Excellence ($75 Fee) Representative Three will attend the following EventsFourth Representative Name First Last Fourth Representative TitleFourth Representatives Email Contact Name and Email of additional individual you want the convention information sent to (Admin. Asst., Office Manager, etc.) Fall Conference Events Wednesday Lunch ($35 Fee) Thursday Lunch ($35 Fee) Spotlight on Excellence ($75 Fee) Representative Four will attend the following EventsConsent My organization will be utilizing our complimentary Platinum Booth at the 2024 Fall Convention.Please note that CHCA Platinum Associte Members have the opportunity to take advantage of one complimentary booth at either the 2024 Spring Conference or the 2024 Fall Convention Exhibiting Contract(Required) I agree to the Exhibiting ContractCONTRACT TERMS & AGREEMENTS: CHCA host organizations, hotel and show management, and employees or representatives of these bodies, will not be held liable for injuries to any person or for any loss or damage to property owned and controlled by the exhibitor, which claims for damages or injuries may be incident to, arise from, or be in any way connected with the exhibitor’s display. The exhibitor shall indemnify and hold harmless the Colorado Health Care Association, the management of the Association and the owners of the Embassy Suites against all such claims. If any legal action is necessary to enforce the terms of this contract, the prevailing party shall be entitled to reasonable attorney’s fees in addition to any to there relief to which he may be entitled. Exhibitors desiring to insure their exhibit merchandise and display material against loss of any kind must do so at their own expense. The Association suggests that such exhibitors contact their own insurance brokers who will secure for them exhibit rider policies which will provide all their home premises for the exhibition purposes. Exhibitors will be responsible for any damage done to the building by them or their employees. Nails, tacks or screws must not be driven into walls, floors, or woodwork. I undertand that reservations will be taken on a first-come, first-served basis and are subject to CHCA Board of Directors approval. Due to CHCA’s nonprofit status, no sales or order-taking will occur during the course of the conference. I have read the contract terms & agreement and understand they are part of this contract. Please note, active recruitment of employees at any CHCA event is prohibited. Δ