Office Use Only Date In___________________ Amount In_________________ Confirm___________________ 2023 Mid-Year Registration August 6 - 9, 2023 • Waldorf Astoria Monarch Beach, Dana Point, CA Registrant Information Register no more than one couple per page 1. Registrant’s Name Badge Name 2. Spouse/Guest Name Badge Name 3. Youth 1 Name Age Badge Name 4. Youth 2 Name Age Badge Name Company Title Street Address City State Zip Phone Fax Cell Phone p I’m a First-time Conference Attendee Registration Info • Email this registration form to registration@ pccaweb.org OR • Mail this registration form with payment to: PCCA PO Box 638 Churchton, MD 20733 Registration Fees All attendees must be registered Registration Category By 6/30/23 After 6/30/23 Subtotal Owner/Employee Member $695 $795 Spouse/Guest (18 years old and above) $495 $595 Youth (7 - 18) $325 $425 Youth (under 6) $0 $0 Optional Activities Please enter registrant’s number (1-4) from above Fees Registrant # PCCA Golf Tournament (Tues.) $390 Golf Club Rental (Tues.) p Mens p Womens | p Right p Left $90 Laguna Beach Art Tour (Mon.) $310 Dolphin/Whale-Watching Tour (Mon.) $260 Kayaking in Dana Point Harbor (Mon.) $265 Cruising the Harbor (Tues.) $275 Mission SJC Wine Tasting (Tues.) $245 A Presidential Tour (Wed.) $245 Total Fees Cancellation Policy There is no charge for cancellations received before 6/30/23. After that date, no refunds will be given. Please confirm cancellation and refund request in writing. Questions? Call us at (800) 542-PCCA Room Type p Garden View Room $395 | p Resort View Room $425 p Pool View Room $450 p Fireside Terrace Room $500 | p 1-Bedroom Suite $750 p King Bed p 2-Queen Beds 2023 MID-YEAR MEETING Waldorf Astoria Monarch Beach, Dana Point, California August 6 - 9, 2023 Hotel Registration Credit card is required to reserve rooms. This is a separately charged item. Card Type: p MasterCard p VISA p AMEX Credit Card Number Expiration V-code Cardholder Name Signature Check-in Date Check-out Date PCCA Fees Payment must accompany this registration in the form of a check or credit card. Payment must be received by June 30, 2023, for early discount. p Check Please make payable to PCCA p MasterCard p VISA p AMEX Credit Card Number Expiration V-code Cardholder Name Signature CC Billing Address
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