TRAVEL PACKAGE REGISTRATION FORM

The Automation Fair® Event 2017  Houston, Texas  November 15-16

Registration Form

Above select the travel package you want to secure. OTHER is only for Horizon Solution custom packages pre-approved and authorized by Horizon Solutions--we will instruct you to select the OTHER option when applicable.

IMPORTANT -- CAREFULLY READ & FOLLOW THE DIRECTIONS BELOW:

As part of all airline reservations, TSA (a division of the Department of Homeland Security) requires the following information as it appears on your driver's license or passport (legal ID that you will present upon check-in at the airport).  MAKE CERTAIN the following information is completed EXACTLY as it appears on your legal ID...  and as it should appear on your airplane ticket. Once you receive your itinerary, review your itinerary immediately. If there are any discrepancies you will need to contact our travel agency (Van Zile) within 24 hours of ticketing, or it will be considered a valid itinerary. Any changes after 24 hours you will incur fees to correct your ticket. **If you type this information incorrectly and it does not match exactly as it appears on your ID (the legal ID that you will present at check-in & security at the airport), you will be charged an additional fee (minimum fee is $150) to correct the error and issue a corrected airline ticket. Review the following information carefully before submitting this form.
  • First Name
  • Last Name
  • Middle Initial (IF it appears on your ID)
  • Suffix (name) (IF it appears on your ID)
  • Date of Birth
  • Gender

** It is important you use a valid email address ** This is where we will be sending ALL confirmation information and updates regarding Automation Fair.

*** Provide the address where you want us to ship your shirts (to wear at Automation Fair) and your other goodies for the show. These items will be shipped to the address you provide below. You will receive them a week or two before the show.

The men's shirt is 3-ounce, 60/40 cotton/poly blend -- Long sleeve, button down shirt.

The ladies shirt is 3-ounce, 60/40 cotton/poly blend -- Long sleeve, button down shirt.

**Note: If you select credit card for payment type you will be contacted directly by Horizon Solutions to obtain your credit card information. Please DO NOT provide credit card information in this form.

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ASSUMPTION OF RISK, WAIVER OF LIABILITY AND RELEASE OF CLAIMS

The Releasor agrees that Horizon Solutions, its subsidiaries, affiliates, shareholders, officers, directors, employees, agents, successors and assigns (collectively the "Releasee") shall not be liable for any damages, injuries, expenses or losses sustained or incurred by the Releasor in connection with traveling, using or participating in the arrangements described below, however caused. The Releasor hereby releases, discharges and waives any claims, demands or causes of actions, known or unknown, the Releasor might have against the Releasee in connection with these arrangements and activities. The Releasor assumes the risk of travel and participation arising from the arrangements made in connection with the Rockwell Automation Automation Fair 2017 in the Houston, TX metropolitan area, which arrangements may include, but are not limited to:
  • Transportation via commercial airline or charter motor coach
  • Hotel accommodations
  • Ground transportation
  • Meals, refreshments, entertainment and group activities

The Releasor further agrees not to initiate any claim, lawsuit, court action or other legal proceeding or demand against the Releasee or join or assist in the prosecution of any claim for money or other damages which anyone may have in connection with the arrangements and activities, and waives any right the Releasor may have to do so. This means that the Releasor cannot sue to hold the Releasee responsible for any injury, loss, or damage sustained by the Releasor, other parties, or the Releasor’s (or others') property in connection with the arrangements and activities, even if it is due to the negligence, injudicious act, omission, or other fault of the Releasee. The Releasor waives its insurers' right to make a claim against the Releasee based on payments by insurers to the Releasor or on the Releasor’s behalf for any reason. This means the Releasor’s insurers have no rights of subrogation against the Releasee.

"Releasor" means, collectively, the undersigned, anyone claiming by or through him/her, his/her heirs, executors, administrators and personal representatives, as well as his/her employer, its owners, officers, directors, employees, agents, successors and assigns. THE UNDERSIGNED HAS READ THE TERMS ABOVE, UNDERSTANDS THEM AND AGREES TO BE BOUND BY THEM. I FULLY UNDERSTAND ALL THE TERMS, AND UNDERSTAND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS. THIS AGREEMENT IS GIVEN FREELY AND VOLUNTARILY AND WITHOUT INDUCEMENT, ASSURANCE, OR GUARANTEE OF ANY NATURE BEING MADE TO ME WITH THE UNDERSTANDING THAT RIGHTS TO LEGAL RECOURSE AGAINST RELEASEE ARE KNOWINGLY GIVEN UP IN RETURN FOR THE CONVENIENCE OF HORIZON SOLUTIONS COORDINATION OF THE ARRANGEMENTS ABOVE FOR THE UNDERSIGNED AND HIS/HER EMPLOYER. BY CHECKING THE BOX BELOW, I ACKNOWLEDGE THAT I HAVE READ AND AGREE TO THE TERMS DETAILED ABOVE. CHECKING THE BOX CONSTITUTES A LEGAL SIGNATURE. I specifically acknowledge and agree that this document is not intended to be a general release subject to limitations and conditions that would otherwise apply under applicable state laws, ordinances, statutes, rules, and regulations (collectively, "Applicable Law"), and additionally agree to WAIVE ANY AND ALL GENERAL RELEASE LIMITATIONS PROVIDED BY APPLICABLE LAW OR ANY RIGHTS GRANTED TO ME UNDER APPLICABLE LAW. These terms shall be construed and interpreted as broadly as possible under the applicable law of the jurisdiction in which the activity takes place.

By checking the box below, I acknowledge that I have read and agree to the terms detailed above. Checking the box constitutes a legal signature.

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