2025 Convention Registration Form

FRVTA State Convention

September 4-7, 2025
JW Marriott Miami Turnberry

19999 West Country Club Dr. Aventura, FL 33180
Registration Form
Company*
Mailing Address:*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number:*
E-mail:*
example@example.com
Region #
First Company Employee*

First NameLast Name
E-mail:
example@example.com
T-Shirt Size (Men's)
Second Company Employee

First NameLast Name
E-mail:
example@example.com
T-Shirt Size (Men's)
Third Company Employee

First NameLast Name
E-mail:
example@example.com
T-Shirt Size (Men's)
Fourth Company Employee

First NameLast Name
E-mail:
example@example.com
T-Shirt Size (Men's)
Child rate applies to Ages 8 - 12; Children under 7 years of age are FREE.

Child rate applies to Ages 8 - 12; Children under 7 years of age are FREE.

	Full Name	Age
Child 1
Child 2
Child 3
Child 4

Please indicate the number of people attending each function.*

	# Attendees
Thursday Welcome Reception
Friday General Session
Friday Awards Banquet
Saturday Game Show Luncheon
Saturday Costume Party

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)

	Golf Outing (Held on Property)	Duck Race (Lunch provided. Must Register to Attend)
Attendee 1
Attendee 2
Attendee 3
Attendee 4

Do you want to copy Mailing address to Billing address?

Yes

Registration Fees:

Purchase a Duck for the Duck Race supporting the PAC FUND

$5.00 Quantity

1st Employee

$450.00 Quantity

# Additional Employees/Spouse(s)

$425.00 Quantity

Child Attendee 8-12 yrs of age

$225.00 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:

FRVTA State Convention

JW Marriott Miami Turnberry

Registration Form