Podiatric Clinical Conference and Exhibition - APPLICATIONS
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Podiatric
Clinical Conference
and Exhibition
APPLICATIONSSPONSORSHIP
APPLICATION P17
CONTACT INFORMATION
Company Name
Mailing Address
City, State, Zip
Contact Name
Contact Phone
Contact Email Address*
*All conference communication will take place via email
SPONSORSHIP LEVEL
Titanium $45,000 Silver $20,000
Platinum $35,000 Bronze $10,000
Gold $25,000 Copper $ 5,000
ADDITIONAL OPPORTUNITIES
Leadership Reception $ 17,500 Daily Break Stations $ 6,000
Lunch Symposium (+ Actual F&B) $ 10,000 Friday Saturday Sunday
Onsite Registration $ 12,500 Directional Floor Decals $ 5,000
Thursday Lunch Symposium $ 10,000 NY20 Countdown Clock $ 5,000
Interactive Exhibitor Locator $ 7,500 Post-Conference Thank You/Survey $ 2,500
Conference Lanyards $ 7,000 Conference Bag Inclusion $ 1,500
Conference Bags $ 6,000 Innovation Theaters $ 1,500
Pocket Guide $ 6,000 Pre-Conference Attendee List $ 350
Attendee Educational Workshop Unrestricted Grant
PAYMENT INFORMATION
A 50% deposit must accompany this form to reserve sponsorship.
Payment is due in full by Thursday, November 4, 2021.
Payment is due in full for all applications received after Thursday, November 4, 2021.
NYSPMA and/or Foundation for Podiatric Medicine will charge the remaining balance Email applications to
to the credit card below on Thursday, November 4, 2021.
dani@nyspma.org
Payment Method:
Fax applications to
MasterCard Visa American Express 646-365-7426
Check Payable to Foundation for Podiatric Medicine
Payment Amount Mail applications to
555 Eighth Avenue
Card Holder’s Name
Suite 1902
Card Number New York, NY 10018
Exp. Date Security Code Card Holder’s Zip Code
Signature
NYSPMA NY22 EXHIBIT HALL HOURS CONTACT
555 Eighth Avenue | Suite 1902 • Friday, January 21, 2022 9:30am - 5:30pm Dani SanMarco, CEM
New York, NY 10018 • Saturday, January 22, 2022 9:30am - 5:30pm dani@nyspma.org
www.nyspma.org/ny22 • Sunday, January 23, 2022 9:30am - 1:00pmEXHIBIT SPACE
APPLICATION P18
Company Name (as it will appear in marketing materials)
Mailing Address (as it will appear in marketing materials)
City, State, Zip
Company Phone Company Fax
Company Website
Contact Name Contact Phone
Contact Email Address*
*All conference communication will take place via email
Company Category (Please list one)
50-word Company Description Please use description from NY20 Included below (or will send today via email)
Booth Selection
1. 2. 3.
Competitors you’d prefer not to be placed next to:
1. 2. 3.
Kindly note that placement cannot be guaranteed, but every effort will be made to honor your requests.
BOOTH SELECTION
Mini Booth: $3,000 Standard Booth: $3,600 Corner Booth: $4,600 Premium Booth: $5,600
No. of booths X Booth Cost $ Total Due
PAYMENT INFORMATION
A 50% deposit must accompany this form to reserve sponsorship.
Payment is due in full by Thursday, November 4, 2021.
Payment is due in full for all applications received after Thursday, November 4, 2021.
Email applications to
NYSPMA and/or Foundation for Podiatric Medicine will charge the remaining balance dani@nyspma.org
to the credit card below on Thursday, November 4, 2021.
Fax applications to
MasterCard Visa American Express Check Payable to NYSPMA 646-365-7426
Payment Amount
Card Holder’s Name Mail applications to
555 Eighth Avenue
Card Number
Suite 1902
Exp. Date Security Code Card Holder’s Zip Code New York, NY 10018
Signature
NYSPMA NY22 EXHIBIT HALL HOURS CONTACT
555 Eighth Avenue | Suite 1902 • Friday, January 21, 2022 9:30am - 5:30pm Dani SanMarco, CEM
New York, NY 10018 • Saturday, January 22, 2022 9:30am - 5:30pm dani@nyspma.org
www.nyspma.org/ny22 • Sunday, January 23, 2022 9:30am - 1:00pmEXHIBITOR
ADVERTISING FORM P19
Company Name
Mailing Address
City, State, Zip
Contact Name Contact Phone
Contact Email Address*
ADVERTISING OPTIONS ADVERTISING SPECS
.125” BLEED .125” BLEED
Registration Brochure Ad $ 500
8.5”W x 11”H + .125” Bleed* Half
Page
.125” BLEED
.125” BLEED
Due: September 30, 2021
5.5”H
Ad
Pre-Conference Postcard Mailer $1,000
8.5”W
6”W x 4”H + .125” Bleed*
.125” BLEED
.125” BLEED
Due: December 17, 2021 Full .125” BLEED
11”H
Onsite Program Ad - Full Page $1,000 Page
8.5”W x 11”H + .125” Bleed* Ad .125” BLEED
Due: December 17, 2021
Postcard
.125” BLEED
.125” BLEED
Onsite Program Ad - Half Page $ 500
4”H
Mailer
8.5”W x 5.5”H + .125” Bleed*
Due: December 17, 2021 8.5”W 6”W
Onsite Program Ad - Inside Front Cover $1,500 .125” BLEED .125” BLEED
8.5”W x 11”H + .125” Bleed*
Due: December 17, 2021 Specs
Onsite Program Ad - Back Cover $ 1,750 • Files should be press-ready PDF, CMYK (no Pantone
8.5”W x 5.5”H + .125” Bleed* colors included), 300dpi images and fonts embedded
• Files should include .125” bleed on all four sides
Due: December 17, 2021
and submitted with crop marks at the trim line
• Logo files should be submitted as vector EPS files
with any Pantone colors converted to CMYK—
TOTAL $ 300dpi JPGs are also acceptable
PAYMENT INFORMATION
MasterCard Visa American Express Email applications to
Check Payable to Foundation for Podiatric Medicine
dani@nyspma.org
Payment Amount
Fax applications to
Card Holder’s Name 646-365-7426
Card Number
Exp. Date Security Code Card Holder’s Zip Code Mail applications to
555 Eighth Avenue
Suite 1902
Signature New York, NY 10018
NYSPMA NY22 EXHIBIT HALL HOURS CONTACT
555 Eighth Avenue | Suite 1902 • Friday, January 21, 2022 9:30am - 5:30pm Dani SanMarco, CEM
New York, NY 10018 • Saturday, January 22, 2022 9:30am - 5:30pm dani@nyspma.org
www.nyspma.org/ny22 • Sunday, January 23, 2022 9:30am - 1:00pmLIABILITY WAIVER
AND RELEASE FORM P20
LIABILITY WAIVER, RELEASE, AND ASSUMPTION OF RISK AGREEMENT
In consideration of being allowed to attend, volunteer, or otherwise participate in any fashion in the
(“Program”), beginning on , , 2021, I, the undersigned participant (“Participant”), agree as follows:
1. P
urpose. It is the purpose of this Liability Waiver, Release, and Assumption of Risk Agreement (“Agreement”) to exempt, waive, and
release The New York State Podiatric Medical Association and its affiliated entity, The Foundation for Podiatric Medicine, and any officers,
employees, volunteers, officials, and agents (“Released Parties”) from any and all liability for personal injury, property damage, and
wrongful death arising out of attendance or participation in the Program to the fullest extent allowed by New York law.
2. Assumption of Risk. I agree and consent that participation in the Program is voluntary and at each individual’s own risk. I acknowledge
that participation in the Program entails known and unknown risks that may result in physical or other injury, loss, or death, including but
not limited to exposure to contagious illness. I understand that such risks simply cannot be eliminated. I expressly assume the risk of
injury and damages and will indemnify and hold harmless, and covenant not to sue, the Released Parties from any and all claims for injury
and damage, even if the risk(s) arise out of the negligence or fault of the Released Parties.
3. Liability Waiver & Release. By executing this Agreement, I agree that the Released Parties shall not be liable for any damages arising
from personal injuries sustained by myself or any licensee or individual under my care, custody, or control as a result of any and all
activities related to participation in the Program. I assume full responsibility for any such injuries or damages that may occur, and
further agree that the Released Parties shall not be liable for any loss, theft, or damage to personal property. I specifically agree that the
Released Parties shall not be responsible for such injuries, damages, loss, or theft, even if caused in whole or part by the negligence of
the Released Parties, whether such negligence is present at the signing of this Agreement or takes place in the future. This waiver and
release does not apply to intentional torts by the Released Parties. I waive, release, discharge, and covenant not to sue the Released
Parties for the claims being released in this Agreement.
4. L
iability to Third Parties. I agree that I will indemnify and hold harmless the Released Parties for all personal injuries, property damage, or
other damage to any and all third parties, including but not limited to parties under my care, custody, and control, as a result of any and all
activities related to participation in the Program, even if such damage arises out of the negligence of the Released Parties.
5. Interpretation. I expressly agree that this Agreement is intended to be as broad and inclusive as permitted by the laws of the State of New
York and shall be governed by the law of New York, without regard to any conflict of laws.
6. Severability. I agree that if any portion of this Agreement is found to be void or unenforceable, the remaining portions shall remain in full
force and effect.
7. Attorney Fees. Should the Released Parties or anyone acting on their behalf be required to incur attorney fees and costs to enforce this
Agreement, I agree to indemnify and hold them harmless for all such fees and costs.
8. Acknowledgment & Signature. By signing this Agreement:
a. I expressly state that I have had sufficiently opportunity to read and consider this entire Agreement and ask any questions associated
with it.
b. I agree that I have read and understood it and voluntarily agree to be bound by its terms.
c. I acknowledge that this Agreement contains a waiver and release of claims.
SIGNED:
Printed Name of Participant Signature Date
NYSPMA NY22 EXHIBIT HALL HOURS CONTACT
555 Eighth Avenue | Suite 1902 • Friday, January 21, 2022 9:30am - 5:30pm Dani SanMarco, CEM
New York, NY 10018 • Saturday, January 22, 2022 9:30am - 5:30pm dani@nyspma.org
www.nyspma.org/ny22 • Sunday, January 23, 2022 9:30am - 1:00pmYou can also read
