2023 Convention Form

Ride the RV Pipeline to Success

FRVTA State Convention
Fort Lauderdale Marriott
Harbor Beach Resort & Spa
3030 Holiday Drive
Fort Lauderdale, FL 33316

(954) 525-4000
Convention Registration Form

September 7 - 10, 2023
Company*
Mailing Address:*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number:*

Area CodePhone Number
E-mail:*
Region #
First Company Employee*

First NameLast Name
T-Shirt Size (Men's)
Second Company Employee

First NameLast Name
T-Shirt Size (Men's)
Third Company Employee

First NameLast Name
T-Shirt Size (Men's)
Fourth Company Employee

First NameLast Name
T-Shirt Size (Men's)
Will Children be attending? Child rate applies to Ages 8 - 12; Children under 7 years of age are FREE.

Yes

Child Attendee:

	Full Name	Age
Child 1
Child 2
Child 3

Please indicate the number of people attending each function.*

	# Attendees
Thursday Welcome Reception
Friday General Session
Friday Costume/Dinner Party
Saturday Game Show Luncheon
Saturday Awards Banquet (not recommended for children)

Friday Afternoon Activities: Space is limited and assigned on a first come first serve basis (Must be 8 yrs or older to attend. All minors must be accompanied by a parent or guardian)

	Fishing Trip	Topgolf Outing
Attendee 1
Attendee 2
Attendee 3
Attendee 4

Do you want to copy Mailing address to Billing address?

Yes

Registration Fees:

1st Employee$425.00

Quantity

# Additional Employees/Spouse(s)$400.00

Quantity

Child Attendee 8-12 yrs of age$200.00

Quantity

Total $0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Should be Empty:

Ride the RV Pipeline to Success

Convention Registration Form