Attendee Activities Form - Georgia Vascular Society

Contact Information

Name*

First Last

Practice Name*

Phone

Email

Choose Your Events

Which events are you interested in?

Golf Tournament
Pickleball Tournament
Sporting Clays Tournament
Tennis Tournament
President's Tailgate

Golf Tournament

How many golf tickets do you need? *

Price: $240.00

Please enter the names of each person participating.*

Pickleball Tournament

How many Pickleball tickets do you need? *

Price: $30.00

Please enter the names of each person participating.*

Sporting Clay

How many sporting clay tickets do you need? *

Price: $100.00

Please enter the names of each person participating.*

Tennis Tournament

How many tennis tickets do you need? *

Price: $35.00

Please enter the names of each person participating.*

President's Tailgate

How many adult tickets do you need? *

Price: $75.00

Please enter the names of each adult participating.*

Do you plan to bring children ages 12 to 18?*

Yes
No

How many (12-18) tickets do you need? *

Price: $50.00

Please enter the names of children ages 12 and older participating.

Do you plan to bring children ages 4 to 11?*

Yes
No

How many (4-11) tickets do you need?

Price: $25.00

Children 3 and under are no charge

Please enter the names of children ages 4 -11 participating.

Payment

Total

$0.00

How would you like to pay?*

Credit Card
Check

Please make checks payable to Georgia Vascular Society, Inc.

Tax ID# 45-4588488

Mail to:

Georgia Vascular Society, Inc.
c/o Burkhardt Planning & Consulting
Attn: Liz Sullivan-Burkhardt, Executive Director
2520 Vestal Parkway East #238
Vestal, New York 13850

Credit Card*

Card Details

Cardholder Name