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1 CO USA
2 Exhibitor Prospectus Come explore Colorado s Rocky Mountains at the Western Pediatric Trauma Conference The conference features nationally renowned faculty in the fields of pediatric trauma, critical care, emergency medicine and pre-hospital care. The program content is targeted to surgeons, nurses and health care professionals from around the nation who care for injured children. The WPTC 2019 will take place in Telluride, Colorado. This event is an unparalleled opportunity to make and solidify relationships through person-to-person communications and marketing. Reserve your sponsorship and/or booth space today! Provided by In collaboration with
3 Support Levels Trauma Red, $10,000 - Premier Level Company name on advertisement board and table tents; company name on display screens within the main conference room at the conference; company name on conference literature; double wide exhibit booth; and announcements throughout the day. Trauma Level I, $7,500 - Lunch/Reception (four available) Company name on advertisement boards and table tents; recognition during the lunch breaks; exhibit booth; and company name on conference literature. Trauma Level II, $5,000 - Breakfast (three available) Company name on advertisement boards and table tents; exhibit booth; and extra visibility and recognition during breakfast. Trauma Level III, $3,000 - Invited Speaker/Conference Social Activity (multiple available) Company name on advertisement boards and table tents; recognition during the lunch breaks; exhibit booth; and company name on conference literature. Trauma Level IV, $1,750 - Abstract, Best Practice, or Point- Coutnerpoint Sessions Company name on advertisement boards and table tents; exhibit booth; and extra visibility and recognition during specific sessions. Lanyard, $ (one available) Company name on lanyards with conference logo and exhibit booth.
4 Western Pediatric Trauma Conference Sponsorship Payment Form, July 17 19, 2019 Firm Name (as you would like it to appear in the acknowledgments) Address City State Zip Phone Number Website Address SELECT A LEVEL Trauma Red, $10,000 - Premier Level Trauma Level I, $7,500 - Lunch/Reception Trauma Level II, $5,000 - Breakfast Trauma Level III, $3,000 - Invited Speaker Trauma Level IV, $1,750 - Session: Lanyard, $3,000 Please a company description (limit 230 characters) as it should appear in the social events program to ray.cuellar@childrenscolorado.org by May 25, The Western Pediatric Trauma Conference reserves the right to edit as necessary for consistency and/ or length. Name of Representative(s) attending the conference Return these forms with payment by May 25, 2019 to: Ray Cuellar, Outreach Coordinator Children s Hospital Colorado, East 16 th Avenue, Aurora, CO 80045, Form may be ed with credit card payment to: ray.cuellar@childrenscolorado.org PAYMENT AMEX Visa Master Card Discover Check Total Enclosed $ Card Holder Name Card Number Expiration Date Security Code Signature
5 Western Pediatric Trauma Conference AGREEMENT for COMMERCIAL SUPPORT of CONTINUING MEDICAL EDUCATION BETWEEN CHILDREN S HOSPITAL COLORADO and a COMMERCIAL SOURCE Regarding Terms, Conditions and Purposes of an Educational Grant Title of Activity: Western Pediatric Trauma Conference Location: Telluride, Colorado Dates: July 17 19, 2019 Commercial Supporter (company name/branch) The above company wishes to provide support for the named continuing education activity by means of (indicate which option below): Educational grant for support of the CME activity in the amount of: $ Restricted grant to reimburse expenses for: Trauma Red, $10,000 - Premier Level Company name on advertisement board and table tents; company name on display screens within the main conference room at the conference; company name on conference literature; and announcements throughout the day. Trauma Level I, $7,500 - Lunch/Reception (four available) Company name on advertisement boards and table tents; recognition during the lunch breaks; and company name on conference literature. Trauma Level II, $5,000 - Breakfast (three available) Company name on advertisement boards and table tents; and extra visibility and recognition during breakfast. Trauma Level III, $3,000 - Invited Speaker Company name on advertisement boards and table tents; recognition during the lunch breaks; and company name on conference literature. Trauma Level IV, $1,000 - Abstract, Best Practice, or Point-Coutnerpoint Sessions Company name on advertisement boards and table tents; and extra visibility and recognition during specific sessions. Lanyard, $3,000 - (one available) Company name on lanyards with conference logo. CONDITIONS 1. Statement of Activity Purpose CE activity is for educational and scientific purposes only. 2. Control of Planning and Execution of Activity Children s Hospital Colorado and its educational partners are responsible for designing and conducting the CE activity, including identification of continuing education needs, determination of educational objectives/learner outcome, selection of content, speakers and educational methods, and evaluation format. 3. Disclosure of Financial Relationships Children s Hospital Colorado will ensure meaningful disclosure of significant relationships (or not) between speakers and commercial interests. 4. Involvement in Content There will be no scripting or influence on content of the CE activity by the Commercial Supporter or its agents. 5. Opportunities for Debate There are opportunities for questioning and scientific debate by participants during the CE activity. 6. Commercial Supporters at Educational Activities Representatives of a commercial supporter may attend the CE activity, but may not engage in sales activities while in the room where the education takes place.
6 7. Exhibits and Promotional Activities No exhibits and commercial promotional activities will be permitted in the same room or obligate path as the educational activity, unless the exhibit is within an area that is designated for general exhibits and includes exhibits from different companies. Amount of support does not determine exhibit placement at this CE activity. When commercial products are displayed at the CE activity, participants will be advised that: Children s Hospital Colorado approved status as a provider of CME/CNE/Other credit refers only to its continuing educational activities and does not imply Accreditation Council for Continuing Medical Education (ACCME) or American Nurses Credentialing Center s (ANCC) Commission on Accreditation endorsement of any commercial product. Promotional products are NOT intended for patient/hospital use and it is the participant s responsibility to go through proper channels at their institution before using any product, drug or device. 8. Management of Contributed Funds from Commercial Source Funds should be in the form of an educational grant with checks made payable to: Children s Hospital Colorado (Federal Tax Identification # ). The purposes and conditions of the educational grant are documented in this Letter of Agreement. No other funds from the commercial supporter will be paid to the activity director, faculty or others involved with this CE activity (e.g., additional honoraria, extra social events, etc.) Upon request, Children s Hospital Colorado will furnish the Commercial Interest documentation detailing the receipt and expenditure of the commercial support. Commercial support is acknowledged in printed course materials, but without reference to specific c products. The Commercial Supporter and Children s Hospital Colorado agree to abide by all requirements of the ACCME Standards for Commercial Support and ANCC Content Integrity Standards AGREED Commercial Company representative (name) Signature Children s Hospital Colorado Shaun Ayon Program Manager, Continuing Medical Education Date Date
7 Exhibit Booths Exhibitor Table, $1500 Standard booths include a 6 clothed and skirted table with two chairs. Exhibit fixtures, components and banners will be permitted to a maximum height of 12 ft. Sufficient seethrough areas must be provided to prevent blocking views of adjacent booths. Lunch for 2 vendors is included in the exhibit fee. Exhibit Dates & Hours Wednesday, July 17 9:30 am to 3:30 pm Thursday, July 18 7:00 am to 2:30 pm Friday, July 19 7:00 am to 9:45 am Exhibit Installation Dates & Hours Tuesday, July 16 2:00 pm to 4:00pm Wednesday, July 17 6:30 am to 9:30am Exhibit Dismantle Dates & Hours Friday, July 20 9:45 am to 12:00 pm Additional representatives may attend for $75/day to cover food costs. Time has been allotted in the agenda for participants to view exhibits. A list of confirmed exhibitors will be available at the conference. To reserve your booth please return your Application and Contract for Tabletop Space and payment by May 25, 2019.
8 Western Pediatric Trauma Conference Exhibitor Payment Form - July 17 19, 2019 Firm Name (as you would like it to appear in the acknowledgments) Address City State Zip Phone Number Website Address SELECT A LEVEL Exhibitor s Table, $1,500 Additional representative $75/day Please a company description (limit 230 characters) as it should appear in the social events program to ray.cuellar@childrenscolorado.org by May 25, The Western Pediatric Trauma Conference reserves the right to edit as necessary for consistency and/ or length. Name of Representative(s) attending the conference Return these forms with payment by May 25, 2019 to: Ray Cuellar, Outreach Coordinator Children s Hospital Colorado, East 16 th Avenue, Aurora, CO 80045, Form may be ed with credit card payment to: ray.cuellar@childrenscolorado.org PAYMENT AMEX Visa Master Card Discover Check Total Enclosed $ Card Holder Name Card Number Expiration Date Security Code Signature
9 Western Pediatric Trauma Conference Western Pediatric Trauma Conference July 17-19, 2019 EXHIBITOR and CE Provider agree to abide by ACCME/ANCC Standards for Commercial Support (SCS) as stated at and continuingeducation: SCS 4.2: Product-promotion material or product-specific advertisement of any type is prohibited in or during CE activities. The juxtaposition of editorial and advertising material on the same products or subjects must be avoided. Live (staffed exhibits, presentations) or enduring (printed or electronic advertisements) promotional activities must be kept separate from CE. EXHIBITOR Exhibitor may display educational materials at their exhibit space only. Distribution of pharmaceuticals, samples or other promotional material is prohibited. Advertisements and promotional materials may not be displayed or distributed in the educational space immediately before, during or after a CE activity. Exhibits may not interfere with the activity presentation. Exhibit placement must not be a condition of the support. Commercial representative may attend the activity but no promotional behavior is permitted in the same room. No additional payments, goods, services or events will be provided to the course director(s), planning committee members, faculty, joint sponsor, or any other party involved with the activity. CE PROVIDER Providers may not allow Representatives to engage in sales or promotional activities while in the space or in the place of the CE activity. Exhibitor fees received will be used to offset the costs of the educational activity. AGREEMENT Company: Exhibitor Fee $ EXHIBITOR Representative: Print Name Signature Date CE PROVIDER Representative: Print Name Signature Date Return one signed copy to: Ray Cuellar - Trauma Outreach Coordinator Children s Hospital Colorado E. 16th Avenue, B245 Aurora, CO Form may be sent by FAX with credit card payment to (720)
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