‘CELEBRATING SISTERHOOD IN SC’
2012 CONVENTION REGISTRATION FORM
September 28-30, 2012
Red Hat Chapter Name_______________________________ Chapter Number _____________
Name of Queen _________________________________________ SC Region______________
Your Name _____________________________
Red or Pink Hat ________________________
E-mail Address _________________________________________________________________
Street Address ___________________________
City __________________________
State ____ Zip Code _________________
Phone Number _______________________________
I heard about the convention from: _________________________________________________
I WOULD LIKE TO BE SEATED WITH: __________________________________________
(Please list the Chapter Name or Individual Name)
Special Needs: Wheelchair/Walker, etc.
_______________________________________________________________________
Special Dietary Needs: Vegetarian, allergies, etc.
_______________________________________________________________________
I hereby grant to SCQC, LLC the right to reproduce, use, , display, broadcast, distribute
and create derivative works of any photographed images of me.
Please acknowledge, by your signature, the above Photo Release & that there will be NO Refund for this Registration:
Signature : ________________________________________
REGISTRATION –
$159 Convention Special (good through Feb. 14, 2012)
$169 Early Bird Special (Feb. 14, 2012 – May 1, 2012)
$179 Regular Registration Price (Unchanged for 7th year)
(Convention cutoff is September 7, 2012 or until SOLD OUT)
NO REFUNDS for Membership, Registration Fee, or special purchase options.
Registration may be transferred to another member. No On-Site Registration will be permitted.
Registration includes $1 associate membership dues to the SCQC,
LLC.
Associate members are entitled to participate in all open SCQC Events. Membership expires in August 2013.
For Credit Cards: Payments can now be made through PayPal.
Please add a processing fee of $5.00 to your total amount due.
From the PayPal Website (www.PayPal.com), send payment to our email address SCQCRegistration@bellsouth.net.
After doing so, don’t forget to indicate on your Convention Registration form the PayPal transaction number & transaction date, and mail the completed form to the address below.
For Checks: Make checks payable to ‘SCQC’
Mail Checks and/or Registration Forms To:
Sandi Fallowes
5117 Sapp Circle
Lake Wylie, SC 29710
________________________________________________________________________
________________________________________________________________________
Optional Payment Plan: $179.00 – no refunds
$59.00 due with Registration Form payable by January 31, 2012 v
$60.00 due payable by March 31, 2012
$60.00 balance due by July 31, 2012
Note: If at any time payments are not received as scheduled
above, all monies will be forfeited and payable to SCQC
Convention Fund.
Yes, I would like to participate in the Optional Payment Plan.
I understand the dollar amounts due & schedule dates as
indicated above, and also understand that monies paid are non-refundable in the event the above schedule is not met.
Signature
________________________________________________________________________
A sneak preview of what’s to come: Get ready for a Blast from the Past!!!
Friday night: What were you wearing in High School??
Saturday night: At the Prom: Red Hat Style!!
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Stay with us at the Convention Host Hotel!
Embassy Suites Hotel
Greenville Golf Resort & Conference Center
670 Verdae Boulevard, Greenville, South Carolina 29607
Our host hotel, Embassy Suites, is offering special convention rates
(Note: payment will be charged to your credit card on 8/6/2012)
We have booked additional hotel rooms this year.
We have sold out the last 2 years!! So don’t wait RESERVE NOW!!!
$109 per night
(same price: Single, Double, Triple, or Quad!!)
3pm Check In … 12 Noon Check Out
Your room reservation includes: a full breakfast each morning
and a hosted social each evening. This special rate requires you to stay both Friday and Saturday nights.
Hotel reservations can’t be cancelled. Additional nights will be available at the same price.
Call 1-864-678-7126 for reservations
Mention ‘Red Hat – SCQC’ to receive these special convention rates.
For additional hotel information visit:
http://embassysuites1.hilton.com/en_US/es/hotel/GSPESES-Embassy-Suites-Greenville-Golf-Resort-Conference-Center-South-Carolina/index.do