2023 Annual Meeting Registration Form - Guest Only For use when registration fees need to be paid separately for company representative and their guest(s). "*" indicates required fields SPOUSE/GUEST/CHILD REGISTRATIONFor use when paying separately for spouse and other guestsCompany Representative:* Member Company:* Company Representative Phone:* Company Rep. Email:* Email to send receiptSpouse/Guest Legal Name* (if not registering a Spouse/Guest type N/A)Spouse/Guest Name for Badge: (if different from legal name)Child's Name:* (if not registering a Child type N/A; if more than one, list names separated by semicolons) Child's Name for Badge: (if different from given name)Spouse/Guest Email: Registration Fees:Spouse or Guest 11 or older:* Price: $650.00 Quantity: FOR QUANTITY: ENTER 0,1,2,3, etc. Prices are in USD. Children Age 10 and under:* Price: $400.00 Quantity: FOR QUANTITY: ENTER 0,1,2,3, etc. Prices are in USD. Events: Friday March 10Newcomers Social - 6 pm (First-Time Attendees) (# of guests attending)Welcome Reception and Dinner - 6:30 pm (# of guests attending)Events: Saturday March 11Breakfast - 6:30-7:30 am (# of guests attending)9:45am - Kendra Scott Color Bar-Jewelry Making + Lunch* Price: $100.00 Quantity: FOR QUANTITY: ENTER 0,1,2,3, etc. Prices are in USD. Events: Sunday March 12Guests participating in the 5K Run/Walk at 8am (# of guests participating)Shirt Sizes for Guests participating in Run/Walk (# of people attending) Guest(s) to participate in the Golf Tournament?*$152 per player. Tee times begin at 11:07am. CANCELLATION POLICY: Within 72 hours of play - no refund. Yes No Guest Golf Fees* Price: $152.00 Quantity: FOR QUANTITY: ENTER 0,1,2,3, etc. Prices are in USD. Handicap(s) for Guest(s) (If multiple separate with a semicolon) Club Rental* Price: $70.00 Quantity: FOR QUANTITY: ENTER 0,1,2,3, etc. Prices are in USD. How many right- and/or left-handed club sets do you need? (Specify L or R handed) Events: Monday March 13Breakfast - 7-8 am (# of guests attending)Annual Reception & Dinner - 6 pm* (# of guests attending)Dinner Options: Meat, Chicken, Fish, Vegetarian* Please note how many of each entrée needed for guests.Payment:Total Payment Type Credit Card Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name
