APCA 2023 Convention

Office Use Only Date In_ _________________ Amount In_ ______________ Confirm__________________ 2023 Convention Registration March 31 - April 5, 2023 Grand Hyatt Baha Mar Nassau, Bahamas Registrant Information Register no more than one couple per page 1. Registrant’s Name Badge Name 2. Spouse/Guest Name Badge Name 3. Youth 1 Name Age Badge Name 4. Youth 2 Name Age Badge Name Company Title Street Address City State ZIP Phone Cell Email Registration Info • Email this registration form to registration@ americanpipeline.org OR • Mail this registration form with payment to: PO Box 638 Churchton, MD 20733 Registration Fees All attendees must be registered Cancellation Policy There is no charge for cancellations received before 1/31/23. After 1/31/23 and before 2/28/23 there will be a 50% cancellation charge. There will be no refunds after 2/28/23 Questions? Call us at (703) 212-7745 Room Type p Ocean View $360 | p Ocean Deluxe Balcony $490 | p King Bed p 2 Queen Beds p Grand Suite $531 | p One Bed Fountain View Res West $601 | p One Bed Fountain View Res West Deluxe $651 | p One Bed Fountain View Res East $751 Room rates are subject to taxes and service charge. Early departures will result in an early departure fee equal to 1 night’s room rate. Hotel Registration Credit card is required to reserve rooms. This is a separately charged item. Card Type: p MasterCard p VISA p AMEX Credit Card Number Expiration V-code Cardholder Name Signature Check-in Date Check-out Date Exhibit p Yes, I Want a Tabletop at the 6th Annual Associates Exhibit APCA Payment must accompany this registration in the form of a check or credit card. Payment must be received by January 31, 2023, for early discount. p Check Please make payable to APCA p MasterCard p VISA p AMEX Credit Card Number Expiration V-code Cardholder Name Signature Credit Card Billing Address p I’m a First-time Convention Attendee Registration Category By 1/31/23 After 1/31/23 Subtotal Owner/Employee Member $1295 $1595 Spouse/Guest $795 $895 Youth under 4 - 10 $345 $445 Youth 11-18 $595 $695 Optional Activities Please enter registrant’s number (1-4) from above Fees Registrant # Rose Island Boat Tour (Sat, 12 - 5 pm) $350 APCA Golf Tournament (Mon, 12:30 - 6:30 pm) $400 Golf Club Rental (Mon) p Mens p Womens | p Right p Left $70 Spouse Breakfast (Tues, 9 - 10:30 am) included Catamaran Snorkel & Sail (Tues, 12 - 5 pm) $200 Total Fees

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