APCA 2023 Mid-Year Meeting

Office Use Only Date In_ _________________ Amount In_ ______________ Confirm__________________ 2023 Mid-Year Meeting Registration October 1 - 4, 2023 The Westin Savannah Harbor Golf Resort & Spa Savannah, Georgia 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: APCA PO Box 638 Churchton, MD 20733 Registration Fees All attendees must be registered Questions? (703) 212-7745 Room Type p Guest Room $269 | p King Bed p 2 Queen Beds 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 APCA Payment must accompany this registration in the form of a check or credit card. Payment must be received by August 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 8/31/23 After 8/31/23 Subtotal Owner/Employee Member $750 $900 Spouse/Guest $500 $650 Youth under 10 $0 $0 Youth 10 -18 $350 $450 Optional Activities Please enter registrant’s number (1-4) from above Fees Registrant # APCA Golf Tournament (Mon., 1 - 6 pm) $200 Golf Club Rental (Mon., 1 - 6 pm) p Mens p Womens | p Right p Left $70 The Historic District Tour (Mon., 1 - 5 pm) $50 Lunch at Paula Deen’s (Tues., 12 - 2 pm) $100 Total Fees