AMBUCS: Convention Registration

Registration fee includes the opening reception/dance; educational/general sessions; scholarships for therapists and awards programs; and president's dinner dance. It also includes two specials events for spouses and guests. (Children 16 or under pay no registration fee. Send for children's program details if you're interested.)

*If you, your spouse and guests are registered in AMBUCS room block at Bally's Las Vegas, give us your room reservation number(s) (see above) and deduct $50 from each registration!

Registration	Before May 2	After May 2	*Discount	Amount Due
Member	$195.00	$210.00	$	$
Spouse	$175.00	$195.00	$	$
Guest	$175.00	$195.00	$	$
Monday, July 6			Quantity
Golf Tournament Handicap(s)		@ $75.00		$
(Please give us a handicap of your average score)

WLW social (WLW members and guests only)		@ $20.00		$

Wednesday, July 8			Quantity
Big Hat Breakfast (ONLY Big Hatters)		@ $18.00		$
			*Total*	$

Dates, time, costs and description of tours will be forwarded to each registrant. Please press "SUBMIT" to e-mail your registration to AMBUCS.

(Currently we are not accepting credit card numbers over the Internet. After submitting this form, please send in your check payable to AMBUCS Resource Center or call or fax your credit card number to us at):

AMBUCS RESOURCE CENTER
PO BOX 5127
HIGH POINT, NC 27262
E-Mail: [email protected]
Phone: 336-869-2166
Fax: 336-887-8451

ADDRESS:
CITY:	STATE: ZIP:
DAY PHONE:	FAX:
BALLY'S ROOM RESERVATION(S) #:

CHILD #1		AGE:
CHILD #2		AGE:
GUEST #1
GUEST #2