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Registration Form (Billing)
CREDIT CARD CHARGE
Today’s Date: ___________________________________
Credit Card Type: _________________________________
Credit Card Number:_______________________________
Exp. Date:______________________ CVV2 Code: _______
Name (as it appears on card):__________________________
Complete Billing Address:____________________________
City:_________________________________________
State:______________Zip Code: ____________________
Telephone:_____________________________________
Email Address:___________________________________
Authorized Signature
Please return registration form by March 15, 2015
with payment or credit card information to:
By mail:
Ken Thompson
133 Golden Pheasant Drive
Slidell, LA 70461
Or Email to: [email protected]
HOTEL INFORMATION:
The Beau Rivage Resort & Casino
875 Beach Blvd. • Biloxi, MS 39530
(228) 386-7111
www.beaurivage.com
ROOM RATES PER NIGHT: $159
Contact hotel directly for reservations.
Block Discount Deadline is March 20, 2015
Dear Rotarians and Guests,
Rotary Rivage 2015 started as a vision. Paul and Brian
wanted to have a District Conference they’d love to
attend. A District Conference that was fun, offered great
fellowship, good fun, an exciting location, and tons of
great Rotary information. They wanted an opportunity
to bring families and have some time to play in addition
to sharing great Rotary time with fellow Rotarians.
At Rotary Rivage 2015, we’ve worked to bring all
those elements together. District 6840’s traditional
FoodFest – you’ve got to see it to believe it – will be
held at beautiful Fort Maurepas in Ocean Springs, MS.
With a beach including a fire pit and pier, playground
equipment for the children, a stage for the live music,
and more great Mississippi and Louisiana food than you
can eat in two lifetimes you’re set for a great time that’s
family friendly.
The Rotary content will include plenaries with great
speakers and breakout sessions including best practices
from clubs and Rotarians from not only our district but
around our zone. You’re going find out how to improve
your membership recruiting and retention, great ideas
on new projects, and how to raise funds. Many of the
sessions are designed to be very interactive so you can
exchange ideas.
And for location, you simply can’t beat the Beau Rivage
in Biloxi, MS. From the meeting spaces to the great
rooms (at just $159 per night!) to the entertainment
options, you’re guaranteed to have a great time.
Don’t miss this chance to meet fellow Rotarians, have a
great time with your families, and strengthen your club.
We look forward to seeing you at Rotary Rivage 2015!
Beau Rivage Resort & Casino
Biloxi, Mississippi
April 10th - 12th, 2015
INFORMATION &
REGISTRATION
Rotary Rivage 2015 Events
Thursday
 Evening reception at the
Beau Rivage
Friday
 Breakout sessions on
various Rotary topics
in the afternoon – hear
what you want to hear!
 Inspiring plenary session
on Friday morning to get
us moving!
Rotary Rivage 2015 Five Way Test
EASY SIGN UP AT: rotaryrivage2015.com
 Is It Fun?
Rotarian’s Last Name______________________________
 Is It Inspiring?
DISTRICT
6820
 Is It of Great Value?
DISTRICT
6840
 Start the day with a great breakfast and an inspiring
speaker!
 More breakouts – interactive sessions about what you
want to discuss!
 Saturday afternoon is free time. Spend some quality
time with your family on the beach, go fishing, or
play a round of golf. It’s
entirely up to you!
 Saturday evening –
Rotary Rivage Luau will
be a laid-back good time
celebrating Rotary in our
two districts.
 Friday and Saturday
at Rotary Rivage are
casual. Come in your
flip fops ready to hit the
beach. Ties are expressly
forbidden.
Sunday
 Enjoy a great brunch
as we wind down Rotary
Rivage 2015 and look
forward to our next Rotary
year together.
Rotarian’s First Name______________________________
Spouse/Partner’s Last Name_________________________
Spouse/Partner’s First Name_________________________
Club Name____________________________________
 Is It Educational?
Spouse/Partner’s Club Name_________________________
 Would You Do It Again?
Text Msg #____________________________________
 Friday night – FoodFest at Fort Maurepas in Ocean
Springs, MS. Bring your appetite!
Saturday
Registration Form
E-Mail ______________________________________ Mailing Address ________________________________
City________________________________________
District Contact Info
District 6820 Central Mississippi
www.rotary6820.org
District 6840 Southeast Louisiana & South Mississippi
www.rotary6840.org
State _____________ Zip________________________
Contact Phone__________________________________
REGISTRATION OPTIONS:
Thursday Golf at Shell Landing:  Yes No (Billed Separately)
Thursday 1/2 day Close-in Fishing:  Yes No (Billed Separately)
Friday Night FoodFest:
 Yes No (No Charge)
REGISTRATION FEE: Early Registrants qualify for a drawing for one of
2 SPA Packages, or 2 free nights at the Beau!
• Register by June 30, 2014 - 5 Tickets in drawing and $49 registration
• Register by November 30, 2014 - 3 Tickets in drawing and
For Additional Conference
Information, Contact:
$59 registration
• Register by January 31, 2015 - 1 Ticket in drawing
and $69 registration
$_________
District 6820
Mark Fields at [email protected]
• Spouse/guests registration @ $30 each District 6840
Karen Babin at [email protected]
# persons ______ at $125 each
$_________
MEALS:
• Full Meal Plan – (Best Deal - Includes ALL of the below)
$_________
• Or, Ala Carte:
 Friday lunch - # persons ______ at $30 each_ $_________
 Saturday morning - # persons ______ at $25 each_ $_________
 Saturday lunch - # persons ______ at $30 each_ $_________
 Saturday night luau - # persons ______ at $60 each_ $_________
 Sunday brunch - # persons ______ at $30 each_ $_________
Total Amount Due: $__________