Name(Required) First Last Email(Required) Phone(Required)Early Bird conference registration: Individual: $400.00 Couple: $600.00 Member-in-training: $200.00 Non Member: $600.00 Physicians Couple Non Member: $800.00 Conference registration after August 1st: Individual: $500.00 Couple: $700.00 Friday, August 30thWelcome Buffet 6:00pm - 9:00pm Karaoke 10:00pm - 11:30pmAdult: Price: $55.00 Quantity: Non Member Adult: Price: $70.00 Quantity: Children: 12 to 17: Price: $25.00 Quantity: Children under 11 (Free) Price: $0.00 Quantity: Saturday, August 31st7:00pm to 10:00pm Kid's Night Out for children 4-12 years: Price: $55.00 Quantity: Please Specify Bellow Child's Name And AgeChildren NameAge Add Remove10:00pm-12:00pm Venezuelan night/ live music dance. This is an adult only eventWill be attending? Yes No How many peopleSunday, September 1st7:00pm- 12:00 Casablanca dinner and dance This is an adult only event. 1940s outfit, inspired by the movie Casablanca. Awards for the most creative couples and single attendeesMember: Price: $150.00 Quantity: Member (Couple): Price: $300.00 Quantity: Non Member: Price: $200.00 Quantity: Other ActivitiesPlease indicate which activity you are going to participate and names of the participants.Golf (Saturday 7:45 Am To 11:30 Am)NameName Add RemoveTennis (Saturday 8:00 Am To 11:00 Am)NameName Add RemoveCycling (Saturday 7:30 Am)NameName Add RemoveSoccer (Saturday 5:00pm To 6:00pm)NameName Add RemoveZumba Class (Saturday 12:00 To 1:00pm)NameName Add RemoveVolleyball (Sunday 3:00pm To 5:00pm)NameName Add RemoveSpecify any food allergies and the name of the guestTotal Options Other Amount HiddenSection BreakPhysician Name PhonePayment Reason Amount Total