Class Member/Spouse or Guest Registration

First Name*
Last Name*
Date of Arrival*
- May 3rd, 2018
- May 4rd, 2018
Time of Arrival*
- Between 2 and 4
- After 4
Explanation*
Has your contact information changed since the last program?*
Special Dietary Needs / Preferences*
Do you plan to Linger Longer on May 5, 2018?*
(If yes, please call Jekyll Island Club Hotel (912) 635-2600 or 1-(800) 535-9547)
- Yes
- No
Register for “Derby de Mayo” $50.00 per person*
Attendance Optional
Price: $50.00
Billing Information
Name*
First Last
Email*
Enter Email Confirm Email
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Billing Information