RSVP for the 2019 CARE Annual Member Meeting

Will you attend the 2019 Annual Member Meeting, Jan 25-27, 2019? *

Yes

No

Member First Name *

Member Last Name *

Pharmacy Name *

Email *

Mobile Phone Number *

May we send text messages with meeting information to this number? *

Yes

No

Home Address *

Home Address

Address Line 1

Address Line 2

City

State/Province

Zip/Postal

Do you plan to bring additional guests?

Yes

No

How many guests?

Guest 1

Please list spouse, children or other guests that will be traveling with you to the CARE Member Meeting.

Is guest staff or family?

Guest Title

Guest Relationship

Is guest at least 18 years of age?

No (please list age)No (please list age)

Yes

Guest First Name *

Guest Last Name *

Guest 2

Please list spouse, children or other guests that will be traveling with you to the CARE Member Meeting.

Is guest staff or family?

Guest Title

Guest Relationship

Is guest at least 18 years of age?

No (please list age)No (please list age)

Yes

Guest First Name *

Guest Last Name *

Guest 3

Please list spouse, children or other guests that will be traveling with you to the CARE Member Meeting.

Is guest staff or family?

Guest Title

Guest Relationship

Is guest at least 18 years of age?

No (please list age)No (please list age)

Yes

Guest First Name *

Guest Last Name *

Guest 4

Please list spouse, children or other guests that will be traveling with you to the CARE Member Meeting.

Is guest staff or family?

Guest Title

Guest Relationship

Is guest at least 18 years of age?

No (please list age)No (please list age)

Yes

Guest First Name *

Guest Last Name *

Guest 5

Please list spouse, children or other guests that will be traveling with you to the CARE Member Meeting.

Is guest staff or family?

Guest Title

Guest Relationship

Is guest at least 18 years of age?

No (please list age)No (please list age)

Yes

Guest First Name *

Guest Last Name *

Rooming Information

CARE will pay for one room per member on Friday and Saturday nights at the Lodge. Upgrades to Townhouses are available for an additional cost. Room Reservations will be managed by Kathy Riddle on behalf of CARE Members. Any issues or questions should be directed to Kathy at [email protected]

Anticipated Arrival Date *

Anticipated Arrival Time *

Anticipated Departure Date *

Anticipated Departure Time *

Bed Preference *

Additional nights will be billed at CARE discounted nightly rates of: Lodge $179, Townhouse $289

Do you need adjoining rooms?

Yes (If so, for how many people?)Yes (If so, for how many people?)

No

Do you want a townhouse for your family or group for an additional $100 a night?

Yes (If so, for how many people?)Yes (If so, for how many people?)

No

Members will be billed for upgrade by the hotel at checkout.

Upgrades will be assigned based on availability at time of reservation.

Dining and Food Options

Do you or your guests have any food allergies or dietary restrictions? *

No

Yes (please list name of person and explain, i.e. allergies, Kosher, etc.)Yes (please list name of person and explain, i.e. allergies, Kosher, etc.)

Will you be attending Saturday evening’s dinner event? *

No

Yes

If yes, will you be bringing a guest to Saturday’s main dinner event?

No

Yes (guest name)Yes (guest name)

Comments or additional requests?