Page 12 - may-june 2019
P. 12

Advanced Registration Form




            Name: _____________________________________ Spouse/Significant Other: _______________________________
            Company: __________________________________ Telephone: ________________________________
            Email: _____________________________________  Spouse Email: ________________________________________


                                                  Registration Fees
            Single Registration: $380      $_______             Couple Registration: $580      $________
            (includes a Reverse Raffle Ticket, Welcome Reception,  (includes two Reverse Raffle Tickets, Welcome Reception,
            Dessert Extravaganza and President’s Dinner)      Dessert Extravaganza and President’s Dinner)
            Non-Members: Individuals from non-member companies will be charged a $150 additional convention registration fee.
                                       Please add this charge to your total registration amount.

                                      Convention Activities and Events
              Additional tickets are available for family members/  Tuesday
                guests not involved in the propane industry and,   Fishing: $180              #_____  $_______
               therefore, not paying convention registration fees.  (Minimum of 10 needed. Fee includes everything needed
                                                               to fish plus food, drinks, tip and fish cleaning)
            Sunday                                             Golf Tournament: $150          #_____ $_______
            Welcome Reception (included in registration)       (Fee includes green fee, cart, drinks, box lunch and prizes)
            Extra Adult Ticket: $25        #_____  $_______    Names                                 Handicap
            Child Ticket (17 and under): Free   #_____         __________________________________  __________
                                                               __________________________________  __________
            Monday
            National Naval Aviation Museum                     Hangin’ on the Beach: $25      #_____ $_______
            Movie: $9                      #_____  $_______    (Fee includes one lounge chair, shared umbrella, snacks
            (Admission to the Museum is free but the movie is extra)  and beverages)
            Extra Reverse Raffle Ticket: $50   #_____  $_______
            Dessert Extravaganza (included in registration)    President’s Dinner (included in registration)
            Extra Adult Ticket: $35        #_____  $_______    Extra Adult Ticket: $120       #_____ $_______
            Child Ticket (17 and under): Free   #_____         Extra Child Buffet (15 & under): $45  #_____ $_______

                  Total Registration Amount                                            $___________


                  Hotel Information (12 Via de Luna Drive):      Donations are needed for the Silent Auction. Contact
              To make your room reservation at the Hilton Hotel for   the LPGA office with your item information or fill out
             June 16-18, 2019 call: 1-866-916-2999 or 1-850-916-2999.   and return the attached form. Thank you in advance!
              To book online, go to: www.hiltonpensacolabeach.com.     Convention Cancellation Policy:
                      Use group/convention code: LGA
                          Room Rates Start at $259                Since we have to give a guaranteed number of
              Room Block Reservation Deadline is May 16, 2019!   attendees for events several days in advance, the
                                                                      cancellation policy will be as follows:
                        Return Form and Payment to:                    *Full refund on or before May 17th
                      Louisiana Propane Gas Association          *Half refund on or between May 17th-May 31st
              13144 Perkins Road, Suite A, Baton Rouge, LA 70810         *No refund on or after June 1st
                   Phone: 225-763-8988, Fax: 225-763-8989       If you fax or email your registration form, you are
                       Email: marica@ccilouisiana.com
            Make check payable to Louisiana Propane Gas Association  considered pre-registered and must call to cancel
            Pay online with credit card: www.Paypal.me/LAPropane                your registration.

    12                                             Alabama Propane Gas Association  |  May / June 2019
   7   8   9   10   11   12   13   14   15   16   17