Clone of 2025 LPOA Member's Picnic Event RSVP Form

DATE =SATURDAY, JUNE 6th, 2026

Time: Dinner will be served from 6:00pm until around 7:30pm

Location: Large Pavilion at Lake #3 Park

Physical Address: 4500 Lakeshore Dr. North Little Rock, AR 72116

RESERVATIONS ARE MANDATORY AND REQUIRED TO ATTEND THIS EVENT along with your individual Full Membership Card.

The LPOA annual picnic will be held Saturday, June 6th starting at 6:00 pm. 2026 membership cards will be required for your meal wristband. Food will be available from 6:00-7:30. Other highlights include music, a Birds of Prey Program, bingo, bounce houses, face painting, Kona Ice and fireworks to close the event. Please RSVP NO LATER THAN 6/1 at 12:00pm with this form so that we have an accurate estimate of individuals that will be attending. Members may bring an additional guest for an additional fee of $20.00 per adult individual (age 13+) and $15.00 per Child (ages 3-12) and must be RSVP’d by the member and paid for by 6/1/25.

MEMBER ADULT #1 Full Name

First NameLast Name

2026 FULL LPOA Membership Number

( on your Gold ID card)

#1 Email

#1 Cell Phone Number

Area CodePhone Number

Member Adult #2

First NameLast Name

2026 FULL LPOA Membership Number

( on your Gold ID card)

Number of Member Adults

Enter 1-2

Number of Member Children

Enter 0 - 4

Number of GUEST Adults

Enter 0-2

Number of GUEST Children

Enter 0-2

Please fill out the following information (including name, age, and member id number) below for they member children associated with your membership and then complete the iformation if you are bringing and paying for a guest to attend. Please remember if you sign up a guest, they need to enter with the Member. All guest fees must be paid at the end of this RSVP before you submit the RSVP.

Child Member #1   First Name   Last Name   Age
Child Member #2   First Name   Last Name  Age
Child Member #3   First Name   Last Name  Age
Child Member #4   First Name   Last Name  Age

Additional FEE Payment REQUIRED at end of this form:
Guest ( 13+) #1   First Name   Last Name    Age
Guest (13+) #2   First Name   Last Name    Age
Child Guest #1    First Name   Last Name   Age
Child Guest #2   First Name   Last Name    Age

2026 LPOA Members PICNIC Event Waiver

Parent/Guardian Waiver Initials Acknowledgement

Initials (eg. ABC)

Please #1 Select the Categories that apply AND #2 the number of attendees in each category. If paying for a guest, you must enter credit/debit information BEFORE you click the SUBMIT button.

LPOA FULL MEMBER- ADULT (ages 13+)Free

Includes 1 adult meal coupon for 2026 LPOA Member Summer Picnic. (Includes food, drink and admission ). Note: IF you are bring guest/s, select the category and # attendees you are bringing. MUST ENTER CREDIT/DEBIT CARD INFO FIRST and then press the Submit button.

# of Adult Members
Item subtotal:

LPOA FULL MEMBER- CHILD (ages 3-12 ) Free

Includes 1 child meal coupon for 2026 LPOA Member Summer Picnic. (Includes food, drink and admission) If you are not bringing any Guests, you may click SUBMIT after you select your # of Attendees.

# of Attendees
Item subtotal:

GUEST FEE - ADULT w/ Member ( ages 13+)$20.00

Includes 1 adult meal coupon for 2026 LPOA Member Summer Picnic. (Includes food, drink and admission)

# of Attendees
Item subtotal:

Guest Fee - CHILD w/ Member (ages 3-12)$15.00

Includes 1 child meal coupon for 2026 LPOA Member Summer Picnic. (includes food, drink and admission)

# of Attendees
Item subtotal:

Enter coupon

Total $0.00

2026 LPOA Full Member Picnic RSVP

Please #1 Select the Categories that apply AND #2 the number of attendees in each category. If paying for a guest, you must enter credit/debit information BEFORE you click the SUBMIT button.

Pay with Credit Card