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Registration
Charles Hall
2023-01-23T13:41:58-05:00
Please enter your information as it appears on your travel documents so that we may begin to make arrangements for your time at the Margaritaville Resort in Hollywood Beach, Florida. If you have any questions regarding your travel or accommodation requests, please contact our Event Coordinator, Mandi Beck at
mandi.beck@simplicitygroup.com
. She will be happy to assist you.
Please enable JavaScript in your browser to complete this form.
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Attendee Information
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Travel and Lodging Information
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Guest Information
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Emergency Contact
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Additional Needs
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Summary
Type
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Qualifying Agent
Qualifying Agent
Sponsor
Staff
Attendee First and Last Name as it appears on your travel documents
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First
Last
Enter information as it appears on your travel documents
Attendee Birthdate
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Attendee Gender
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Enter information as it appears on your travel documents
Attendee Cell Phone Day of Travel
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Attendee Preferred Email
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Agent Preferred Name on Award
*
Attendee Preferred Name for Name Tag
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First
Last
Attendee Shirt Size
*
Men - XS
Men - XS
Men - S
Men - M
Men - L
Men - XL
Men - XXL
Men - 3XL
Men - 4XL
Women - XS
Women - S
Women - M
Women - L
Women - XL
Women - XXL
Women - 3XL
Women - 4XL
Attendee Excursion of Choice
*
Airboat Everglades Tour
Airboat Everglades Tour
Offshore Fishing (adults only)
Paddle Board and Kayak Eco Tour
Spa (adults only)
Day at Leisure
Excursions Based on Availability (Confirm Your Choice Today).
Next
Will you be flying or driving to Hollywood Beach, Florida?
*
Flying
Flying
Driving
Preferred Departure Airport
*
Preferred Airline (if any)?
i.e. Delta, United, etc.
Airline Frequent Flyer Rewards Number (if any)?
Preferred Seat on Airplane
Window
Window
Middle
Aisle
No Preference
TSA Pre-Check/Clear Number (if any)?
Preferred Choice of Bed (Not Guaranteed)
*
Two Queens
Two Queens
One King
No Preference
Any Special Travel or Lodging Requests?
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We encourage you to bring your spouse, partner or other adult guest on our trip and we will cover their expenses to attend all group activities and meals. We also understand that in some cases, it is important for you to include your children on this fun trip. We welcome them to attend where is it appropriate, at your expense. Please contact our Event Coordinator Mandi Beck if you have any questions.
How Many Guests are You Bringing
*
None
None
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Guest #1 Information
Enter information exactly as it appears on their travel document.
Guest #1 First and Last Name on travel documents
*
First
Last
Enter information as it appears on travel documents
Guest #1 Birthdate
*
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Guest #1 Gender
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Guest #1 Relationship to Attendee
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i.e. spouse, child, etc
Guest #1 Preferred Name for Nametag
*
First
Last
Name that they would prefer for name tag
Guest #1 Shirt Size
*
Men - XS
Men - XS
Men - S
Men - M
Men - L
Men - XL
Men - XXL
Men - 3XL
Men - 4XL
Women - XS
Women - S
Women - M
Women - L
Women - XL
Women - XXL
Women - 3XL
Women - 4XL
Guest #1 Excursion of Choice
*
Airboat Everglades Tour
Airboat Everglades Tour
Offshore Fishing (adults only)
Paddleboard and Kayak Eco Tour
Spa (adults only)
Day at Leisure
Excursions based on availability (Confirm your Choice Today)
Guest #2 Information
Enter information exactly as it appears on their travel document
Guest #2 First and Last Name on travel documents
First
Last
Enter information as it appears on travel documents
Guest #2 Birthdate
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Guest #2 Gender
Enter information as it appears on travel documents
Guest #2 Relationship to Attendee
i.e. spouse, child, etc
Guest #2 Preferred Name for Nametag
First
Last
Name that they would prefer for name tag
Guest #2 Shirt Size
Men - XS
Men - XS
Men - S
Men - M
Men - L
Men - XL
Men - XXL
Men - 3XL
Men - 4XL
Women - XS
Women - S
Women - M
Women - L
Women - XL
Women - XXL
Women - 3XL
Women - 4XL
Guest #2 Excursion of Choice
*
Airboat Everglades Tour
Airboat Everglades Tour
Offshore Fishing (adults only)
Paddleboard and Kayak Eco Tour
Spa (adults only)
Day at Leisure
Excursions based on availability (Confirm your Choice Today)
Guest #3 Information
Enter information exactly as it appears on their travel document
Guest #3 First and Last Name on travel documents
First
Last
Enter information as it appears on travel documents
Guest #3 Birthdate
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1933
1932
1931
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1921
1920
Guest #3 Gender
Enter information as it appears on travel documents
Guest #3 Relationship to Attendee
i.e. spouse, child, etc
Guest #3 Preferred Name for Nametag
First
Last
Name that they would prefer for name tag
Guest #3 Shirt Size
Men - XS
Men - XS
Men - S
Men - M
Men - L
Men - XL
Men - XXL
Men - 3XL
Men - 4XL
Women - XS
Women - S
Women - M
Women - L
Women - XL
Women - XXL
Women - 3XL
Women - 4XL
Guest #4 Information
Enter information exactly as it appears on their travel document
Guest #4 First and Last Name on travel documents
First
Last
Enter information as it appears on travel documents
Guest #4 Birthdate
MM
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1922
1921
1920
Guest #4 Gender
Enter information as it appears on travel documents
Guest #4 Relationship to Attendee
i.e. spouse, child, etc
Guest #4 Preferred Name for Nametag
First
Last
Name that they would prefer for name tag
Guest #4 Shirt Size
Men - XS
Men - XS
Men - S
Men - M
Men - L
Men - XL
Men - XXL
Men - 3XL
Men - 4XL
Women - XS
Women - S
Women - M
Women - L
Women - XL
Women - XXL
Women - 3XL
Women - 4XL
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Name of Emergency Contact
*
First
Last
Contact not currently travelling with you
Phone of Emergency Contact
*
Previous
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Attendee or Guest Dietary Needs?
I.e. food allergies, etc.
Attendee or Guest Celebrations During Trip?
Is there a special occasion or event you or your guest will be celebrating while on the trip? i.e. birthday, anniversary, etc.
Any Additional Needs or Requests?
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