Seminar Registration

Required fields are marked with *

(Each exhibitor must register and indicate company name below.)

NOTE: If spouse is also an American National agent, please have him/her complete a separate Seminar Registration Form.

Designation(s):
Please select up to five.
Guest(s):
Awards Banquet:

RELEASE OF LIABILITY

By checking the box below, I understand that I am eligible to participate in the 2019 Professional Seminar ("the Seminar"), sponsored by the Multiple Line Division of American National Insurance Company.

In consideration of the Company paying part of the expenses of my participation, I hereby release the Company, its directors, officers, employees and agents of and from any and all liability for claims or causes of action of any nature whatsoever which I or my personal representatives might assert against the Company as a result of my travel to and from the Seminar, my hotel stay in connection therewith, my participation in any Seminar activity and any other activity in which I choose to engage related to said Seminar.

I further release the Company, its directors, officers, employees and agents from any and all liability for claims or causes of action of any nature whatsoever which I or my personal representatives might assert against the Company as a result of my travel either before or after the Seminar, but which I have undertaken in conjunction or in combination with the Seminar.

This release of liability shall be binding upon me, my heirs, executors, administrators and assigns.