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» Resort & Spa » Ocean Activities » Golf Tournament » Educational Sessions » Ocean View Rooms
For more information call 808-737-1991 or email [email protected]
May 19-21, 2017Kaanapali Sheraton - Maui
2016-17 D5000 CONFERENCE
Conference ChairsJoanne & Larry Laird
REGISTRATION FORM
Name: ___________________________________________________________ Rotary Club ___________________________
Address: ______________________________________________________________________________________________
City: ________________________________________________________ State: _________ Zip _______________________
Phone: __________________________ Email: ______________________________________________________________________
Number of Guests Attending: _____________ Name(s): _____________________________________________________________________
2016-17 D5000 Conference
DOING GOOD in the World
Room Rates: $199+
OPTIONS: q Full Conference Registration Including all meals:
Early Bird - $335 (Deadline is November 30, 2016) Normal Price - $399
q Ala Carte Conference Registration: $50 (Extra choices below)
q Friday Evening Reception: $50
q Saturday Breakfast: $50
q Saturday Lunch: $50
q Saturday Evening Gala & Million Dollar Dinner: $175
q Sunday Brunch: $50
TOTAL: __________
PAYMENT INFORMATIONName: ________________________________________________
Credit Card No: _________________________________________
Card Type: qVISA qMASTERCARD qAMEX
Exp Date: ________________CVV Code: ____________________
Billing Address: _________________________________________
City: ________________________ State: _____ Zip: ___________
Please make checks payable to: Rotary D5000
I am interested in the Friday Tennis Tournament
I am interested in the Friday Golf Tournament
I will be attending the Major Donor Reception
I will be attending the Polio Champion Reception
I am a White Hat Society Member
I will be attending the Sunday Morning Ecumenical Service
qYES qNO qYES qNO qYES qNO qYES qNO qYES qNO qYES qNO
Additional Activities:
SAVE THE DATERegister Online at www.D5000Conference.org
May 19-21, 2017Kaanapali Sheraton - Maui
2016-17 D5000 CONFERENCE
Conference ChairsJoanne & Larry Laird
DOING GOOD in the World
For more information call 808-737-1991 or email [email protected]
Join us to celebrate our commitment to service above self and...
» Educational Seminars
» Dynamic Speakers & VIP Events
» Club & Individual Awards
» Rotary International Foundation Million Dollar Dinner