Children/Guest Name Age Dealer Convention Registration Name:______________________________________ Company:_________________________________ Contact Number:___________________________ Address:____________________________________ City/State/Zip:_______________________________ Email: ________________________________________ WVADA Sponsor Registration Fees Registration received after May 19 will incur an additional 15% charge Registration Cut-Off Date: June 1, 2022 In the event that a person should need to cancel - cancellation must be received by WVADA 14 days prior to convention for refund of fees For questions please contact Haley Justice hjustice@wvcar.com 304-343-4158 Once you complete this form, please email or mail the form to Haley Justice. An invoice will be sent via email. x x x x x Sponsor: Guest: Children(13-17): Children(5-12): Children(0-4): _____ _____ _____ _____ _____ ______ ______ ______ ______ ______ $450 $450 $175 $125 $0 ___________ Grand Total = = = = = Payment Calculation Payment Method: Check: Credit Card: *Disclaimer: There will be a 3% charge when paying by credit card. WVADA 88th ANNUAL FAMILY CONVENTION SPONSOR REGISTRATION FORM Nemacolin Woodlands Resort JUNE 12 - 15 Issue 1 2022 15 WVADA
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