Name
*
First Name
Last Name
Name for Badge
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
District Name
Club Name
CREDENTIALS: Please select ALL that apply:
State President
Member
Guest
Voting Delegate** (All GCG Board Members, GCG Life Members and one member from each club are Voting Delegates; please check this box if applicable)
1st GCG Convention
Club President
District Director
Council President
Former State President
State Board Member
State Life Member
Former Deep South Director
Deep South Board Member
Deep South Life Member
Former National President
National Board Member
National Life Member
Dietary Needs
*
Yes
No
List Special Dietary Needs.
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Full registration
Includes registration for all days ($40 non-refundable),Tuesday luncheon, Breakout Sessions, Awards Banquet, and Wednesday Luncheon)
$
190.00
Late Fee
On or after April 18, 2025
$
30.00
Tuesday one-day Registration
Includes meetings and workshops, vendor and educational exhibits access; Non-refundable
$
30.00
Tuesday Opening Luncheon
Must be registered for the day also.
$
45.00
Tuesday Awards Banquet
Must also be registered for the day.
$
60.00
Wednesday one-day Registration
Includes meetings, educational exhibits; Non-refundable
$
30.00
Wednesday Luncheon
Must also be registered for the day
$
45.00
Single Day Registration Late Fee
On or after April 18, 2025
$
30.00
Number of days
1
2
Payment Methods
Credit Card
Apple Pay
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Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
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