SCCPMA Convention Registration Form

Registrant Information

First

Last

Phone Number

Used in case of emergency

Company

Family Members

Will you be bringing a Spouse or Significant Other?

Will you be bringing any young adult children?

Children 21 or over

Will you be bringing any children?

Children under 21

Family Information

Spouse or Significant Other

First

Last

Phone Number

Used in case of emergency

Young Adult Children

How many young adults?

First

Young adult 1

Last

First

Young adult 2

Last

Children

How many children ages 4-12?

How many children ages 13-20?

Child 1

First

Last

Age

Will this child participate in the complimentary kid's program?

Yes

Kid's program is for children 4 - 12 years old

Child 2

First

Last

Age

Will this child participate in the complimentary kid's program?

Yes

Kid's program is for children 4 - 12 years old

Child 3

First

Last

Age

Will this child participate in the complimentary kid's program?

Yes

Kid's program is for children 4 - 12 years old

Child 4

First

Last

Age

Will this child participate in the complimentary kid's program?

Yes

Kid's program is for children 4 - 12 years old

Child 1

First

Last

Age

Child 2

First

Last

Age

Child 3

First

Last

Age

Child 4

First

Last

Age

Does anyone in this family have any of the following dietary restrictions?

Lacto-vegetarian no meat, seafood, poultry, eggs; may include dairy
Ovo-Vegetarian no meat, poultry, seafood, dairy; may include eggs
Lacto-Ovo-Vegetarian no meat, seafood, poultry; may include dairy, eggs
Pescatarian no meat, poultry; include fish/seafood, dairy, eggs
Vegan no meat, poultry, seafood, eggs, dairy

Please list the individuals along with their related restrictions

Are there any food allergies?

Please list the allergies

Special Requests

Registration Fees

Back

Activity Information

Select the number of participants for each activity

Golf - $350 per person Includes Cheerwine BBQ Lunch, beer, soft drinks, and water. Limited tee times available.
Skeet Shoot Over Water Excursion - $350 per person Includes skeet, round-trip transportation, buffet lunch, and beer/wine. Limited space available.
Mixology Class - $350 per person Includes crafting 3 cocktails, paired with complementary small bites and insider tips.

Golf

Skeet Shoot

Mixology

Golf

First

Golfer 1

Last

Handicap

First

Golfer 2

Last

Handicap

First

Golfer 3

Last

Handicap

First

Golfer 4

Last

Handicap

Skeet Shoot

First

Guest 1

Last

First

Guest 2

Last

First

Guest 3

Last

First

Guest 4

Last

Mixology

First

Guest 1

Last

First

Guest 2

Last

First

Guest 3

Last

First

Guest 4

Last

Back

Activity Fees

Running Total: $

Text

Type something.

Text

Type something.

Text

Type something.

Text

Type something.

Text

Type something.

Final Step

Would you like to make a donation to the auction for the purpose of purchasing items for the auction?

All proceeds benefit the SCCPMA Scholarship Fund

Donation Amount

Would you like to buy a raffle ticket(s)?

Enter the number of tickets you would like to purchase

Raffle tickets are $10 each

Total

Registration fees cannot be refunded after June 1. Before June 1, 75% of registration fees will be refunded for cancellations. Cancellations must be made in writing. Individuals who register after June 1, but do not attend, will be charged the full registration. The registration fee does not cover the cost of sleeping rooms. Registrations will not be processed without payment.

Choose a method of payment

Will pay by check, please send me an invoice

Credit Card

Select option to proceed

Back

Submit

Thank you, your registration has been submitted.

If you have any questions, please contact our office via email (info@sccpma.com) or by phone (803-765-9570)

Taking you to the payment page, DO NOT close this page yet...

If you are paying for sponsorship or fishing registration by credit card, please be sure to complete that step next to ensure payment is properly applied to your registration.

If you are paying for sponsorship or fishing registration by check, you will receive an invoice with details of how to submit your remittance.

Protecting You for More than 100 Years

Registrant Information

Family Members

Family Information

Spouse or Significant Other

Young Adult Children

Children

Child 1

Child 2

Child 3

Child 4

Child 1

Child 2

Child 3

Child 4

Does anyone in this family have any of the following dietary restrictions?

Activity Information

Select the number of participants for each activity

Golf

Skeet Shoot

Mixology

Final Step

Thank you, your registration has been submitted.

Taking you to the payment page, DO NOT close this page yet...