people purpose passion - Illinois Funeral Directors Association

June 22-25, 2015
Illinois Funeral
Directors Association
PEOPLE, PURPOSE, PASSION
Peoria Civic Center & Marriott Pere Marquette
Peoria, IL
ANNUAL
CONVENTION
2015
The Future
is Now

Education to guide you in a rapidly
changing world

Networking to help you make new
connections

Largest education and tradeshow
convention in Illinois dedicated to
keeping you on the cutting edge
of the latest concepts, services
and products available
Keynote
Mike Hinrichsen,
35+ year Caterpillar
leader, author and
publisher of “The Little
Black and Yellow Book.”
www.ifda.org
PEOPLE
Illinois Funeral Directors Association
2015 ANNUAL CONVENTION
June 22—25, 2015
PEORIA, IL
PEOPLE PURPOSE PASSION
PURPOSE
PASSION
Cool Tools and Hot Trends to help you meet
the challenges of tomorrow head on.
In this hectic fast-paced world isn’t it time to take a
break and head to Peoria and get refreshed, come
away with new ideas and find solutions to your
most pressing challenges?
Helping you prepare for the future by providing new
perspectives and practical information is the goal of
the Illinois Funeral Directors Association Annual
Convention. At the IFDA Annual Convention you will
find:
PROFESSIONAL DEVELOPMENT THAT CAN’T BE
BEAT. This is the one show of the year where you
can find solutions that drive productivity and give
you and your funeral home operations a competitive
edge for your business. With over 17 hours of CE
offered, you can’t go wrong!
Peoria Civic Center
201 SW Jefferson Avenue
Peoria, IL 61602
A TRADESHOW WITH A LOT OF VARIETY. This is an
opportunity to see the latest offerings from vendors
you are already using, as well as meet with new
vendors whose products and services support the
funeral service profession. IFDA’s expo will help you
generate new ideas, stay up-to-date on the latest
innovations and source suppliers for specific needs.
AN IDEAL ENVIRONMENT TO MAKE CONNECTIONS.
One of the features of this convention is the
connections you can make while attending. If you
can see the benefit of meeting “you” at another
funeral home, the IFDA Annual Convention is a great
place to meet peers and expand your professional
network. Make beneficial connections that invest in
your career.
REGISTER AND PLAN YOUR TRIP TODAY!
PEOPLE
2015 Convention Agenda
PURPOSE
PASSION
PEOPLE
PURPOSE
PASSION
IFDA KEYNOTE
MIKE HINRICHSEN
What Does the World’s Largest Manufacturer of Earthmoving
Machines Have in Common with the Members of the Illinois
Funeral Directors Association?
Just about everything.
Mike Hinrichsen
RESUME
Wrote the book
entitled The Little
Black and Yellow
Book.
Leads the Corporate
Accounts Division
for the Americas.
Is a 35+ year
Caterpillar leader.
Keynote support provided by
The Little Black & Yellow Book captures many areas experienced over a 35+ year
career at Caterpillar that have made a difference in how individuals and
organizations perform at a high level. Attitude, the value of a smile, building
trust, humility, emotional intelligence, managing conflict, negative feedback,
collaboration, passion, goals and developing a vision are a few examples of
similarities to both businesses.
It’s Really Not About You
Tuesday, June 23, 2015 | 9:00am—10:00am | 1 GECE
Mike Hinrichsen is the author of “The Little Black and Yellow Book”, written as his gift
back to Caterpillar on his 35 year service anniversary sharing the lessons learned during
his sales and customer experience. The title of this presentation represents that
leadership through serving consistently provides the highest rewards and personal
satisfaction. To prepare for today's message Mike has done research and interviewed
several Funeral Directors across the state. He will share his book’s message and
reflections on the similarities to Caterpillar and building successful relationships.
You’ll learn how to:

Develop understanding of key human performance enablers at Caterpillar
and similarities to your business.

Advance your understanding of ways to implement key human performance
enablers within your business.
Mike has been blessed to have experienced a long and interesting career at
Caterpillar serving in various leadership responsibilities around the world.
Today Mike leads a division of the Corporate Accounts Division for the Americas.
He is a 35+ year Caterpillar leader whose career has included postings in
Geneva, Switzerland (twice), London, Kuwait, Dubai, North Carolina, Canada and
Peoria.
OVER 17 HOURS OF CE AVAILABLE! REGISTER TODAY!
NETWORKING
PEOPLE
PURPOSE
PASSION
AT ITS BEST
Early Arrival Meet & Greet
Monday, June 22 | 7:30PM—10:00PM
Kelleher’s Irish Pub
Be sure to join us on Monday evening for the Meet
& Greet! After traveling all day, enjoy a relaxing
evening with friends and colleagues. Join us as we
gather for a fantastic night of networking, live
music, snacks and beverages. Shuttle from the
Hotel to Kelleher’s provided by the Peoria CVB.
(Beverages on your own.)
President’s Party
Tuesday, June 23 | 7:00PM—10:00PM
Open to all full conference
registrants and exhibitors. Join us in
celebrating newly installed IFDA
President Stephanie Deiters. This
hors d’oeuvres reception won’t
leave you wanting anything more
thanks to CFL Pre-Need!
Be sure to wear your dancing shoes! JammSammich
will be playing tunes all night long courtesy of State
Auto Insurance
Companies.
Lunch in the Exhibit Hall
Wednesday, June 24 | 11:00AM—2:00PM
Earn two hours of continuing education credit by
checking out the latest funeral related goods and
services on the exhibit floor. Enjoy lunch and the
chance to network with exhibitors as well as your
fellow funeral directors.
Tuesday, June 23, 2015 | 2:00PM—3:00PM
Professional Session & Service of Remembrance
One of the traditions we carry with honor is the Service
of Remembrance. For one brief moment we reflect on
those that we have lost over the past year. We will
hold this year's Service of Remembrance in conjunction
with the Professional Session.
Wednesday, June 24 | 10:00AM—11:00AM | 1 GE
Consumercentric
Rich Darby
The Ritz-Carlton hotel chain is known
throughout the world for its
extraordinary focus on providing
exceptional service and luxurious
amenities. This customer-centered
approach is expressed by the company’s motto: “We
are ladies and gentlemen serving ladies and
gentlemen.” As a guest at any
Ritz-Carlton hotel you will notice the brand’s famed
personal touch immediately upon checking in, when
you are greeted by name.
Other customer service initiatives include the CLASS
(Customer Loyalty Anticipation Satisfaction System)
database that contains the preferences and
requirements of repeat Ritz-Carlton guests, and the
CARE (Clean and Repair Everything) room maintenance
system that ensures all guestrooms are checked and
free of defects every 90 days. Such initiatives helped
Ritz-Carlton become the only service company to win
the Malcolm Baldrige National Quality Award twice and
they’ve enabled Ritz-Carlton to forge long-lasting
customer relationships. What if we took this approach
in our funeral homes? This session will look through the
eyes of a consumer and show you how to adapt your
facility and the conversation to become consumer
friendly.
REGISTER BEFORE JUNE 5TH AND SAVE $50!
ANSWERS
TO THE CHALLENGES YOU FACE
SPEAKERS
& PROGRAMS
In-depth sessions and more time for discussion and sharing.
Tuesday, June 23 | 8:00AM—9:00AM | 1 FD
Have the Talk of a Lifetime
Linda Darby
The goal of the Talk of a Lifetime Campaign is to improve the public perception of
memorialization and funeral service professionals while increasing consumer preference for
meaningful memorialization. This session will show us how the Funeral and Memorial
Information Council (FAMIC) is working to change consumer attitudes towards
memorialization. We will learn from those who have been successful in engaging the
Campaign and how we can apply those successes to our benefit.
Tuesday, June 23 | 10:00AM—12:00PM | 2 EMB
Facial Reconstruction & Restorative Techniques
Wallace P. Hooker
This two hour session is broken into two parts. The first half will review 5 case studies of
actual reconstructive cases with photos shown with family permission, the progression from
initial trauma through the end result of an open casket viewing. The second hour features a
live demonstration of facial reconstruction using RATH (restorative art teaching heads) with
matching traumatic injuries.
Tuesday, June 23 | 1:00PM—2:00PM | 1 FD
IDFPR...Big Brother or No Big Deal?
Keri Ginger | Martha Reggi
For most of us we collect our CE hours, obtain our license, and go about our merry little way.
But, for some it’s a little more complicated than that. Who do you call when you have a
licensing question? Where can you find the information that you need? This session will
provide some insight into the configuration of the department, valuable resources and a
better understanding of the licensing and disciplinary process.
Tuesday, June 23 | 3:00PM—5:00PM | 1 GE 1FD
Dealing with 21st Century Media: “You’re Always On the Record”
Sue Castorino | Randy Minkoff
If someone from the “media” contacted you via your Facebook account for a comment, what
would you do? What if what they asked you about was something that was posted on your
Facebook account? This session will give us a better understanding of how media has
changed and the impact social media adds to the mix. Privacy is a concept that is quickly
becoming extinct!
DISCOUNT REGISTRATION RATES APPLY THROUGH JUNE 5TH.
IFDA SEMINARS
INVEST IN YOUR FUTURE
Real world solutions for your
toughest challenges.
E
Wednesday, June 24 | 8:00AM—10:00AM | 2 FD
Marketing Cremation for Profitability
Mike Nicodemus
Cremation is here and will soon be the “standard” in service provided to families. However, the
key component that many funeral directors miss out on providing is “the service.” Many
families want more than just direct cremation. And, many funeral directors have the
misconception that cremation only involves just that, cremation. The truth is that it can be far
from that. This session will show you that not all families want direct cremation, but they need
YOU to guide them through their options. This session will explain how the way you market
cremation has a direct impact on increasing your revenue.
Wednesday, June 24 | 8:00AM—10:00AM | 2 FD
Lessons From Four Generations: Ownership/Management/Family
Bruce Buchanan
This presentation, geared to owners, will provide a proactive approach to learning from the
experience of those who have done it before. Learn what has worked and what wasn’t so
successful. The session will also touch on the results of the lack of effective management and
family owned businesses.
Wednesday, June 24 | 10:00AM—11:00AM | 1 FD
Legislative Update
John W Humes III, CFSP, CPC
This session will give a rousing round up on happenings at the Capital. Learn the latest on
legislation that we have been keeping an eye on and all that is relevant to the funeral
profession.
SPECIAL THANKS TO OUR
Continuing Education Sponsor
Illinois Wilbert Manufacturers
REGISTER AND PLAN YOUR TRIP TODAY!
IFDA SEMINARS
INVEST IN YOUR FUTURE
Find new perspectives to expand
your thinking
Wednesday, June 24 | 2:00PM—3:00PM | 1 FD
Cremation Phone Shoppers: How Do You Respond?
Julie A. Burn, CCrE, CSE
This session will demonstrate how to portray a memorable first impression to consumers
requesting information on cremation. Examples of “good” and “need improvement”
impressions will be shared as well as ways to fully promote the value of your firm’s offerings.
Wednesday, June 24 | 2:00PM—3:00PM | 1 GE
Navigating the “C’s” of Communication
Cindy Byrd
In any type of organization there can be rough waters when it comes to communicating
effectively because everything we do sends a message. This session offers easy-to-implement,
effective approaches for being a more concise, conscientious, considerate and compelling
communicator.
Wednesday, June 24 | 3:00PM—3:50PM | 1 EMB
Embalming/Facial Reconstruction Tips & Techniques
Wallace P. Hooker
This presentation begins with a brief introduction and opening remarks concerning the
importance of quality embalming. It also touches on the potential parallel between the
increased rate of direct cremation and a history of unsatisfactory embalmings. We will cover a
variety of common sense tips and techniques as well as procedures and products. This session
will be of value to the student, intern and seasoned embalmer. It is an interactive presentation
encouraging questions.
Wednesday, June 24 | 4:00PM—5:00PM | 1 EMB
The Final Touch
Wallace P. Hooker
This presentation covers everything we do to a body following the embalming, until the family
has their first viewing. It covers common sense topics we routinely see overlooked. Everything
from hygiene, dressing, cosmetics, positioning, lighting, flag folding for a veteran, options for off
premise viewing/funerals, processions, etc. So many times we loose sight of the smallest details
which make all the difference to the families we serve.
REGISTER AND PLAN YOUR TRIP TODAY!
IFDA SEMINARS
AT ITS BEST
Wednesday, June 24 | 3:00PM—5:00PM | 2 FD
Idea X-Change
Randall L. Earl, CFSP
Take advantage of this special opportunity to interact
with peers. Engage in conversation with colleagues
sharing ideas, experiences and best practices regarding
common problems and issues. Each roundtable
discussion focuses on one general topic to allow for
active discussion among participants after a brief
introduction by the roundtable facilitator.
Topic starters include:
There’s no denying it anymore. Cremation is a gamechanger. Family wants/needs are changing. The “cash
cow” status quo of embalming is slipping away. For
discussion we will contemplate the questions:
*Where Do You See the Funeral Business in 5 Years?
*With Cremation Rates Increasing, How Do You
Maintain Your Business Income?
*With Cremation Rates Increasing, How Do You
Anticipate Maintaining Your Embalming Skills?
We encourage you to submit additional topic ideas
for discussion. We will collect and prepare them for
discussion confidentially. Maybe you would like to
discuss pre-need licensing, advertising, community
programs, workplace issues, etc. Whatever it may be,
you can submit your ideas to Mary Carey @
[email protected].
Certified Crematory Operators Program
Thursday, June 25 | 8:00AM—4:00PM
Mike Nicodemus, NFDA Vice President,
Cremation Services
Mike Watkins, CFSP, NFDA Senior Vice
President, Operations
Cremation rates across the country
are still on the rise and the Midwest
is no exception. As this trend
continues, it is more important than
ever for funeral directors to learn
how to protect themselves and the
families they serve from the
potential risks surrounding
cremation. This program offers a
must-have certification for everyone offering
cremation to the families they serve. Whether you
are currently operating a crematory, thinking of
opening one, or want to evaluate a third-party
crematory, this training is necessary for your
success.
The recognized standard for funeral service
professionals, NFDA's Certified Crematory Operator
Program™ covers cremation ethics, crematory
operations and maintenance, safety, compliance
and liability issues, cremation customer service, and
much more.
This course is based on Cremation Standards for
Funeral Service Professionals, published by NFDA,
which attendees receive at the seminar. Obtaining
CE and CCO certification requires passing the online
NFDA CCO Certification Test within a designated
timeframe. A test link is provided to candidates
whose complete attendance has been verified in
writing by the onsite instructor. To register follow
this link—CCO Program, go to the NFDA website or
the IFDA website for registration information.
IFDA 2nd Annual Advocacy PAC Auction
ALL MONEY RAISED
BENEFITS THE IFDA
ADVOCACY PAC.
*Items will be on display throughout the Convention, but bidding
will close at 3:30pm on Wednesday, June 24.
*Come prepared to bid on items!
*Call Drew Edwards (Legislative Committee Chair) if you have
items to donate—217-442-2874
CHECK OUT ALL THAT PEORIA HAS TO OFFER—WWW.ENJOYPEORIA.COM
SOLUTIONS
TO KEEP YOU AHEAD OF THE GAME
The IFDA Exhibit Hall has everything you need to efficiently run your
funeral home…..and keep you updated on rapidly changing
technologies.
IFDA’s exhibit hall features all the leading brands and services on
display for you to see, try out and compare. Visiting the exhibit hall is
a great way to:

Stimulate new ideas for you and your funeral home.

Get a hands-on feel for new products, equipment and technology.

Review offers from multiple suppliers at one time.

Meet suppliers you are considering doing business with or have
done business with before.
A large variety of funeral care industry service providers are featured.
Take advantage of this opportunity to get a look at products and
services that can make you more productive and cutting-edge.
Thank You to our
2015 Sponsors!
LIABILITY/PHOTOGRAPHY WAIVER
By registering for the IFDA Convention, you agree and acknowledge
that you are participating in IFDA events and activities on your own free
and intentional will. You acknowledge this freely and knowingly and
that you are, as a result, able to participate in IFDA Convention events
and hereby assume responsibility for your own well-being. This
acknowledgement includes your guest(s) participation in any tours and
evening events.
The IFDA Convention plans to take photographs and video during the
2015 Convention and reproduce them in IFDA educational, news or
promotional materials, whether in print, electronic or other media,
including the IFDA website. By participating in the IFDA 2015
Convention, you grant IFDA to reserve the right to use your name and
photograph for such purposes. All postings are property of IFDA and
may be displayed or used by IFDA for any purpose.
ALL KINDS OF THINGS
TO SEE AND DO
A highly efficient way to meet vendors and check out equipment, products and serGet a first look at new products and services. Take a walk through the hall and explore the many
products and services that will make you , your home and your programs more productive and
THE IFDA TRADESHOW
cutting-edge.
Aftermath Services LLC
Inman Shipping Worldwide
All City Communications
Intuitive Solution Group
American Airlines
Keith M. Merrick Company, Inc.
Artco Casket Company, Inc.
Keystone Funeral Home Design Build
ASD-Answering Service for
Knauer Industries
McDaniels Marketing
Directors
Astral Industries, Inc.
Meadow Hill
Aurora Casket Company, LLC
Messenger
Baines Professional Vehicles
Mid-America Transplant Services
Baldauff - Florida Shipping & Crematory
Miller Architects & Builders
Muster Coaches
Services
Bass-Mollett Publishers
Batesville
Nixon Consulting Inc./ Heartland
Funeral Solutions
Beads-n-More
Pekin Life Insurance Company
CFL Pre-Need
Peoria Wilbert Burial Vault Co.
Church & Chapel Metal Arts, Inc.
Pierce Company
Commemorative Rosaries
Preneed and Perpetual Care Fund
Continental Casket Company
Management
Cremation Systems
Remembrance Creations, LLC
Criswell Casket Company
Royal Coachworks, Inc.
Dodge Company
Saving Sight
Eagle Burial Vault
Security National Life Insurance Company
Eversight Illinois
Shanghai Custom Tailors and Shirt Maker
FDLIC
Shiva Shade
Federated Funeral Directors of
Southwest Professional Vehicles, Inc.
Armbruster - Stageway
America
Funeral Service Credit Union
State Auto Insurance Companies
Futura Funeral Trust
Trust 100
Gift of Hope Organ & Tissue Donor Network
Worsham College of Mortuary Science
Hanley Coach Sales
Hoffman Burial Supplies, Inc.
Homesteaders Life Company
*AS OF PRESS TIME
ASSOCIATE MEMBERS
Visit www.ifda.org for the latest list of vendors
REGISTRATION INFORMATION
Our registration fee structure allows you to pay one low fee to attend both days or any single day of the
Convention.
All licensees employed by an IFDA Member Funeral Home with paid 2015-2016 IFDA Membership Dues may register
for the Convention at member rates. A multi-day registration includes all social events and educational programs
for every day of the Convention. A single-day registration includes all educational programs and all social events
offered for which you register.
Not an IFDA Member yet? Now’s the time to join! Members receive complementary Continuing Education Hours.
That means as a BENEFIT OF MEMBERSHIP at any IFDA sponsored Continuing Education Program including
conventions and seminars, the only cost to attend IFDA CE sponsored programs is a fee for the cost of food and
beverage. Join today by completing the enclosed IFDA Membership Application insert and you can begin to enjoy
the benefits of membership for less than the cost of one multi-day nonmember convention registration.
REFUND POLICY
We know that funeral directors’ schedules can change suddenly. Therefore we offer a full refund provided IFDA is
notified in writing on or before the end of business 4:30pm on June 24, 2014. NO REFUNDS WILL BE GIVEN PAST
THAT DATE. Please email your cancellations to [email protected] or fax it to 217-525-8342. So, there’s no reason not to
take advantage of the Discounted Registration Rates! Register Today!
Please note—if you should need to cancel, it is your responsibility to cancel any room reservations you may have.
And, the hotel’s cancellation policy would differ from ours.
HOTEL RESERVATIONS
The newly renovated top to bottom, Peoria Marriott Pere Marquette is
our host hotel. It is connected to the Peoria Civic Center via a covered
walkway. The group rate is $139 per night s/d. To make reservations,
please
click
the
link
below
or
call
309-637-6500 and reference the IL Funeral Directors Association
Convention. The reservation cutoff deadline is June 1, 2015. After
June 1 all guest rooms not reserved are released for general sale.
Reservations must be guaranteed with a credit card. Reservations must
be cancelled by 6pm the day before arrival in order for the deposit to be
refunded. Self-parking is included with the room rate. Valet parking is
available. Check-in is 3pm, check-out is Noon.
Book your group rate for Illinois Funeral Directors Convention 2015
PEORIA MARRIOTT PERE MARQUETTE
501 MAIN STREET
PEORIA, IL 61602
WHY IT’S IMPORTANT TO
STAY AT THE HOST HOTEL
1. Keep your registration fees
low! The hotel p r ovides
complimentary meeting rooms
for IFDA if, and only if, we meet
the required minimum guest
rooms in our hotel contract.
2. Networking opportunities!
By staying at the host hotel,
you're at the epicenter for
everything IFDA.
3. Save your legs and gas!
If you're not staying at the host
hotel, you'll have to spend some
energy walking or money on a
taxi or parking to come over to
the events. Why bother? Stay at
the center of it all.
Illinois Funeral
Directors Association
PEOPLE, PURPOSE, PASSION
ANNUAL
CONVENTION
June 22-25, 2015
2015
Peoria Civic Center/Peoria Marriott Pere Marquette
Peoria, IL
IFDA
215 S. Grand Ave. West
Springfield, IL 62704
IFDA HELPS YOU
STAY AHEAD OF THE GAME
Everything is moving so fast and IFDA is right here to lead
you into the future. At the IFDA Annual Convention you’ll
find new perspectives to expand your thinking and new
ideas to take home and implement right away.
Grow professionally. You’ll find fresh leadership ideas, new
ways to do your job better and strategies to handle
recurring challenges with staff and client families.
Improve your programs and facilities. In sessions and at the
tradeshow, you’ll be surrounded by expert speakers and the
industries leading companies who will provide practical and
relevant information.
Find solutions to your challenges. Collaborating with
professionals in a variety of fields will give you new insights
and the opportunity to learn from people’s successes and
mistakes.
www.ifda.org
REGISTER
TODAY!
Return to: IFDA
215 S. Grand Ave West
Springfield, IL 62704
Registration Form
Fax: 217-525-8342
_______________________________________________________________________(______)__________________(______)_____________
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meeting registrants. Initial here ____ if you do not want your contact information included in conference materials.
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Is this your first IFDA Annual Convention? Yes No, been coming for ____________ years!
My top three goals in attending the Convention: ________________________________________________________________
____________________________________________________ ___________________________________________________
What is your age?
25-35
36-45
46-55
What level of purchasing power do you have?
Final decision maker Input with decision maker
I intend to make a purchase:
56-65
66-75
offer recommendations
at the show within the next 6 months
76-80
no input/influence
within a year
Discounted rates apply through June 5, 2015. Regular price applies to all registrations received after close of business
June 5th. Only onsite registrations will be accepted after June 12th on a space-available basis.
I would like to register as the following:
Licensed Member #__________________________
Non-Licensed Spouse/Guest of Member
Licensed Non-Member #__________________________
Spouse/Guest
Child
Exhibitor Seeking CE
Student
Multi-Day- $175
Multi-Day - $175
Multi-Day - $540
Multi-Day - $240
Multi-Day—$0
Multi-Day—$100
Multi-Day—$100
$125
$125
$490
$190
Tues
Tues
Tues
Tues
Tues
Tues
Tues
Wednesday - $150
Wednesday - $150
Wednesday - $315
Wednesday - $205
Wednesday - $0
Wednesday—$55
Wednesday—$55
$100
$100
$265
$155
AMOUNT DUE:
By submitting this registration form you agree and accept the Liability and Photography Waiver listed as part of this
registration form.
PAYMENT
CHECK ENCLOSED
CHARGE MY CREDIT CARD
Total Amount Due:
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IFDA GOLF OUTING
Monday, June 22, 2015
11:00 am Registration and Lunch
12:00pm Shotgun Start
Metamora, IL
PRIZES
&
CONTESTS
$125—includes greens fees, golf cart, golf outing shirt,
pre-outing lunch, unlimited fun and networking!
REGISTRATION DEADLINE: JUNE 12, 2015
Player Name: __________________________________________________________________________________________________________
Organization: __________________________________________________________________________________________________________
Office Phone: _______________________________________
Email: ___________________________________________________________
Cell Phone: _________________________________________
(For day of event communication only.)
Shirt Size: Small
Medium
Large
X-Large
XX-Large
XXX-Large
If there is an individual/group with whom you would like to play, please write their name(s) below. We will make every
attempt to accommodate your request. The Outing will be a Best Ball format.
Preferred Twosome/Foursome (each participant must complete and return a registration form)
1. _______________________________________________________ 2. ________________________________________________________
3. _______________________________________________________
4. ________________________________________________________
Waiver of Liability: In consideration of my entry, I, my heirs, executors and administrators waive all claims, release from all liability, and agree to
hold harmless, IFDA, its agents, members and sponsors of this event for any and all injuries and damages suffered by me in connection with this
event. I understand that this outing entails personal risk, and I voluntarily assume that risk.
Signature __________________________________________________________________ Date: ____________________________________
Player Fee: $125 each Check # ______________ Visa/MasterCard/American Express # ______________________________________________
Exp. Date _______________________ Name on Card: _________________________________________________________________________
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Return Form by fax to: 217-525-8342
IFDA * 215 S Grand Ave, West
Springfield, IL 62704
DT RECVD _____________
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