Georgia Rotary Student Program  Annual Conclave

Georgia Rotary Student Program
 Annual Conclave - Districts 6900, 6910 & 6920

 

Registration Form
GRSP Conclave - August 18-20, 2017

On-line registration ends August 11, 2017.
If you have registered but need to modify your registration data or pay use this link (click here).

The 2017 Georgia Rotary Student Program Conclave Check-In Location is

Charles H. Kirbo Regional Center
at Bainbridge State College

2500 E. Shotwell Street
Bainbridge, GA 39819

             There are two actions required by you:

         1) Your room reservations need to be made directly with the hotel.

Holiday Inn Express & Suites Bainbridge
(40 room block)
1413 Tallahassee Hwy   Bainbridge, Ga  39819
229-246-6771
 
Hampton Inn Bainbridge
(30 room block)
1522 Tallahassee Hwy   Bainbridge, Ga  39819
229-246-1341
 
Best Western Executive Inn
(30 room block)
2800 US Highway 84 E Cairo, Ga  39828
800-780-7234

2)  Register and Buy Meals

      
Fill in the On-Line
Registration Form Below - Pay with Credit Card or Check.

There is no registration fee to attend the 2017 Conclave educational and training programs through the day
on Friday and Saturday. Participants attending Conclave dinners on Friday and Saturday night
are asked to pay for their meals as indicated below. 
There is no charge to GRSP students who register. 

  Dinner reservations must be received by 5 pm on Sunday, August 13.

Please fill in your data and follow instructions below to
       send this form to the GRSP Conclave Committee.
If you enter a valid email address, you will receive a copy of the completed form.

* First Name:          Last Name:     * Required data.
* Mailing Address:    
* City:         * State:    * ZIP:  
* Phone:           Email:  
  Rotarians please provide your organization data. Non- Rotarians or out-of-state select District "Other" .
GRSP Students select your sponsor District and one of your sponsor Rotary Clubs.
** Select District Number     
& Club Name:   
   District:         Rotary Club:          
Rotary Title:         If you don't find your title, select "Other Title" .
 

If you are bringing your spouse or guest(s), please enter their name(s) below.
(separate names with commas)
Enter names as you would like them to appear on the badge(s).

Your Number of Guests:          Additional attendees -  not counting person registered above.
Your Guest Name(s):    

                    >>MEAL SELECTIONS<

           Enter Meal Quantity desired:
 

    

FRIDAY                                           
Select the number of meals wanted
 and indicate the choice of menu entrees for each order:

Friday Night Dinner
:   $25 Each
  

Please Enter Entree for each meal ordered    
( Pork or Chicken  ):
  

Friday Night Buffet:     
Entrees :

Pulled Pork BBQ
OR  Smoked Chicken Pcs (white and dark)
Sides:
Cole slaw
Baked beans
Garlic knots/yeast rolls
Dessert

 SATURDAY                                      
Select the number of meals wanted
and indicate the choice of menu entrees for each order:

Saturday Night Dinner:   $35 Each  

Please Enter Entree for each meal ordered    

( Pork or Chicken )
:
 

Saturday Night Buffet: 
Entrees :

Smoked pork chops
OR Grilled Chicken Breast Quarter
Sides:
Strawberry Romaine Salad
Corn casserole

Southern Green Beans

Texas Caviar

Rolls
Banana Pudding/Pecan Pie


                         >> STUDENT TRANSPORTATION<<
                         If you are transporting a GRSP Student or Students to the Conclave, please enter their name(s) below.
                         If you are a GRSP Student, please tell us who you are riding with to the Conclave below.
                         

                         >> CHECKOUT <<
                
           2 Steps - (1) Select your method for payment  (2) Transmit Form to registration office

Select Method of Payment                     

    Pay online with a Credit Card

    Mail a check
                          Press "Transmit Form and Pay" to send this form to the Conclave Committee and move to the payment page.               
                           

Total Cost  = $  

               
                        To start over press "Reset"