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International Interactive Gaming Conference 2016

12 September 14 September 2016


Fairmont Hotel
Conference Registration Form
The preferred method of registration is via the web at
www.internationalinteractivegamingcongress.weebly.com
Tax Invoice ABN:
Date:
Please complete and return this form along with your payment to:
Nicolich Industries
Toa Payoh HDB Hub
#02-31
Singapore, 310480
Phone: +65 8228 2944
Email: IIGC2016@outlook.com
Important Notes:
All prices are in Singapore Dollars (SGD) and inclusive of Goods and Services Tax (GST)
By completing this registration form, you understand and agree to the cancellation policies
and the privacy statement as stated on this form and website.
Please ensure that forms are completed and are not missing out any relevant fields. The
registration will not be accepted should there be any of uncompleted or missing forms.
We would recommend that you keep a copy of the completed form for your own record.
Contact Details
Mr
Ms
Mrs
Miss Dr
Prof
Others, please specify:
Last Name
Middle Name
Front Name
Organisation
Position
Address
Suburb/Town
State
Country
Postcode
Work Phone
Work Fax
Mobile
Name Badge: Please indicate preferred name for your conference badge
Last Name
Middle Name
Front Name
Role at Conference: Please select only one
Delegate
Invited Speaker
Sponsor

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Registration Form

International Interactive Gaming Conference 2016


12 September 14 September 2016
Fairmont Hotel
Conference Registration
Registration Type
Full Registration
Day One Registration
Day Two Registration
Day Three Registration
Total

Early Bird Special


(Up to 12 June 2016)
$550
$250
$250
$250
SGD

Standard Rate
(After 12 June 2016)
$650
$300
$300
$300
SGD

Social Functions
Inclusive of Conference Dinners
The conference dinner is only applicable for delegates that register for full registration. Please
indicate if you were to attend the dinner for catering purposes. Full registration delegates need
not buy additional function tickets.
Welcome Dinner
Yes
No
Gala Dinner
Yes
No
Farewell Dinner
Yes
No
Additional function tickets for day registrations / partner / guest
Additional tickets cost $100 SGD each. Please select the dinner you will be attending and
specify the number of tickets for each dinner required.
Welcome Dinner
Yes
No
Number of Tickets
Gala Dinner
Yes
No
Number of Tickets
Farewell Dinner
Yes
No
Number of Tickets
Dietary Requirements
Delegate
Vegetarian
Vegan
Allergies:
Guest
Vegetarian
Vegan

Gluten Free

Halal

Gluten Free

Halal

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Registration Form

International Interactive Gaming Conference 2016


12 September 14 September 2016
Fairmont Hotel
Allergies:
Accommodation
Hotel
Fairmont Hotel*
Fairmont Hotel*

Room Type

Room Rate (per


night)
Premier Room
$460 SGD
Executive Club
$550 SGD
Total (One Night Deposit) SGD

Booking Details
No. of Occupants Per Room
Arrival Date
Departure
Date
Special Accommodation Requirements
I would like to share the room with

Arrival
Time
Departur
e Time

How did you find out about the conference?


Direct Email
Received Information
Notification
Through Mail

Preference

Fees will apply for rooms with greater


occupancy than indicated by bed sizes
AM/PM Extra charges may apply
for check in before 3pm
AM Check out before 10 am

Website Search

Special Requirements For The Conference


Please list any
Wheelchair
Interpretation Services, Please
special requirements
Access
specify language:

Word of Mouth

Others, Please
Specify:

Payment
All charges are already inclusive of GST. All payments must be made in Singapore Dollars. Charges paid
by credit card will appear as IIGC on your credit card statement. Please transfer all sub totals from the
sections above and check your calculations carefully.
Registration Fee
Social Functions
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Registration Form

International Interactive Gaming Conference 2016


12 September 14 September 2016
Fairmont Hotel
Total SGD
Method of Payment
All amounts on this form are in Singapore Dollars (SGD) and include 7% Goods and Service Tax (GST)
Cheque
Cheques to be mailed to the conference office
Cheques to be payable in SGD$ to IIGC 2016
Bank Transfer When sending a bank transfer, Bank DBS
Account Name IIGC 2016
please send a remittance advice to the
Branch Number 034
conference office via email to
Account Number 109-34567-8
IIGC2016@outlook.com

Credit Card
Card Holder Name
Card Number
Signature

VISA

All bank fees must be covered by the delegate.


MasterCard
American Express
Diners
CCV
Expiry Date

Terms & Conditions


Cancellation Terms
Cancellation of registration informed through email send to the conference office by 1 August 2016 will
be refunded fully. Cancellation of registration made between 1 August 2016 and 19 August 2016 will only
be refunded 50% of the registration fee. Should cancellation be accepted, the fee refunded will require an
administrative fee of SGD$100.
Cancellation of registration made after 19 August 2016 will not be accepted nor refunded. Should there be
any substitution in registration, please ensure that the full name and details of the person that will replace
you are mailed to the conference office two weeks prior the event. Transfer of registration will not be
accepted after 26 August 2016.
No refunds will be given if you did not attend the event.
To qualify for early bird: The registration form and payment must be made by 12 June 2016. Forms and
payment received after 12 June 2016 will not be considered as early bird applications and will be charged
the normal rates.

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Registration Form

International Interactive Gaming Conference 2016


12 September 14 September 2016
Fairmont Hotel
Social Events Conditions
Cancellation must be informed through email send to the conference office by 19 August 2016.
All costs will be refunded should the cancellation be accepted. Cancellations made after 19 August 2016
cannot be accepted nor refunded.
Accommodation Conditions
Credit card details are required to secure an accommodation and the hotel will charge one nights deposit
30 days prior to the conference.
*Hotel rooms are subject to availability.
Should there be a cancellation of accommodation, it must be informed through email send to the
conference office by 19 August 2016. All costs will be refunded. Cancellation after 19 August 2016 will
not be accepted nor refunded. The hotel will continue to charge the full accommodation rate.
Privacy Statement
Use of Personal Information
The conference will collect and store information provided in the registration form so as to enable us to:
Register your attendance at the conference
Assist with administrative and planning purposes
Plan and develop other events in the future
Allow the compilation and analysis of statistics relevant to the conference
The conference has all rights on the information written in the registration form so as to continue to
provide and improve its conferences and services.
Conference Delegate List
There will be a delegate list that is supplied to registered attendees and exhibitors of the conference. Please
note that only the delegates name, affiliation and location will be provided in the delegate list. Should any
registrants want to withhold its information, you may do so by contacting the conference office by 26
August 2016.
Disclosure of Personal Information to Third Parties
The conference may disclose some of the information on the registration form to conference sponsors and
exhibitors for marketing purposes. Please be informed that only your name, email address, organisation
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Registration Form

International Interactive Gaming Conference 2016


12 September 14 September 2016
Fairmont Hotel
and its location will be used.
The conference will not, otherwise, use or disclose any personal information unless it is reasonably
expected that the purpose of using it is to improve the conference where such purpose is permitted by the
law. Registrants are allowed to withhold its information. You may do so by contacting the conference
office by 26 August 2016.
I have read and understood the terms and conditions
Signature

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Registration Form