Exhibitor Registration Form

Mountain States Ground Water Expo | February 10, 2022 - February 11, 2022

Aquarius Casino Resort Laughlin, Nevada

*Indicates required fields.

Company Name*:
Required field

Name for Booth Sign:

Contact Person before the show*:

Required field

Required field

Contact Information for Program


Address: City: State: Zip:




Event Badge(s)

Name(s) for Badge(s): 4 complimentary badges with booth; additional badges $80.00 each
(Non-Exhibiting Manufacturer’s Rep./Suppliers must register separately to attend the Expo)

Exhibitor Badge
Full Name Full Name
Contractor Guest Badge
Full Name Company


8’x10’ booth(s) at $700 each by October 31, 2021; $750 after October 31, 2021 (Includes 2 Friday lunch tickets and 4 drink tickets good for Thursday)
To give more folks a chance to exhibit, indoor booth spaces are limited to two per Exhibitor
Includes 2 Friday lunch tickets and 4 drink tickets good for Thursday

Outside Display(s) at $400 each (NOTE: Space is Unassigned - first come, first choice)

Inside/Outside Combo at $900 by Oct. 31, 2021; $1000 after Oct. 31, 2021 (includes 8 badges)

NOTE: If there is a company you do not want to be next to in the exhibit hall, please provide the company name below.

Pick your booth location

Type your booth number choices: 1 2 3

Number of Additional Badges @$80.00 per badge

Number of additional tickets to Friday’s buffet lunch in Exhibit Hall @$15.00 per ticket

We would like to help Sponsor the Exhibitor Hospitality Evening

$500 Platinum Sponsor (includes 8 drink tickets)

$300 Gold Sponsor (includes 6 drink tickets)

$200 Silver Sponsor (includes 4 drink tickets)

$100 Bronze Sponsor (includes 2 drink tickets)

$200 Friday Lunch Sponsor

$25 Single Raffle Ticket

$100 5 Raffle Tickets

Please send a company logo JPG file to info@mountainstatesgroundwater.com for signage recognizing your sponsorship, NO LATER THAN JANUARY 4, 2022

I would like to donate (Enter numbers only) $ to the Buck Lively Scholarship Fund.

We would like to advertise in the Program distributed at the Expo

Full page @ $250.00 Half page @ $200.00 Business card @ $100.00

Send all artwork to info@mountainstatesgroundwater.com NO LATER THAN JANUARY 4, 2022