InformationRegistrationAdditional RepsBoothsAttendeesDoor PrizesPaymentSetup Information GAHRA Annual Conference September 14, 2025 - September 16,2025 at the Savannah Marriot Riverfront Hotel located at 100 General MacIntosh Blvd. in Savannah Georgia 31401 - Phone 912-233-7722 EXHIBITOR RESERVATION AND CONTRACT Please complete all items. Information regarding program, advance mailing, and exhibitors' directory and listing in the program will be compiled from the information given on this form. This form, including payment, must be submitted and received by August 31, 2025 to ensure your information will be included in the program. HOLD HARMLESS CLAUSE The exhibitor assumes the entire responsibility and liability for losses, damages, and claims arising out of the exhibitors activities on the Hotel premises and will indemnify, defend, and hold harmless the Hotel, its agents, servants, and employers from any and all such losses, damages, and claims. No refunds will be given except for sickness or death and request is to be made by September 1, 2025. Download Conference Packet I have read to the information above and the information contained above. *This field is required.This field is required. Next Registration Please see the attached sponsorship matrix which lays out opportunities to sponsor our conference and receive additional perks and best of all a tax deductible contribution. W-9's will be provided to each sponsor as well as the appropriate perks will be facilitated based on your contribution. Contact Gary Erwin for more details. Sponsorship Benefits - view the benefits of each level RegTypeProfessional Registration - $275.00Exhibitor Registration - $575.00Bronze - $750.00Silver - $1,000.00Gold - $2,500.00Platinum - $5,000.00This field is required. Previous Next Price Subtotal Registration Total Additional Reps Additional Reps - $175.00This field is required.This field is required.Check this box to add more representatives to your registration. Update the quantity to the right. You do not need to include the reps included with your base registration. QuantityThis field is required. Total DelegatesThis field is required. Additional Reps Registration Total Previous Next Package DelegatesThis field is required.Number of attendees included in the selected packet. Additional DelegatesThis field is required.Number of additional attendees added. If you chose a registration option that includes a booth, please indicate which booth you would prefer in order of preference. You may view the Booth Floor Plan Please understand that every effort will be made to reserve the booth of your choice, but we cannot guarantee it. The sooner we receive your payment and executed contract, the better chance you will have. 1st ChoiceSelect...No BoothBooth 3Booth 4Booth 5Booth 7Booth 8Booth 9Booth 10Booth 11Booth 13Booth 15Booth 16Booth 18Booth 19Booth 20Booth 21Booth 22Booth 23Booth 24Booth 25Booth 26Booth 30Booth 31Booth 32Booth 33Booth 35Booth 36This field is required. 2nd ChoiceSelect...No BoothBooth 3Booth 4Booth 5Booth 7Booth 8Booth 9Booth 10Booth 11Booth 13Booth 15Booth 16Booth 18Booth 19Booth 20Booth 21Booth 22Booth 23Booth 24Booth 25Booth 26Booth 30Booth 31Booth 32Booth 33Booth 35Booth 36This field is required. 3rd ChoiceSelect...No BoothBooth 3Booth 4Booth 5Booth 7Booth 8Booth 9Booth 10Booth 11Booth 13Booth 15Booth 16Booth 18Booth 19Booth 20Booth 21Booth 22Booth 23Booth 24Booth 25Booth 26Booth 30Booth 31Booth 32Booth 33Booth 35Booth 36This field is required. Cart Total Previous Next Information The Drop down lists are populated from the file: /wp-content/plugins/gahra.org/wsf_hooks.php Inside that file is a list of field numbers that must be updated if the field number above changes. The list of available booths can be edited at https://www.gahra.org/2025-annual-conference/booth-management/ Attendees Delegate 1 Full Name *This field is required. Badge Name *This field is required.First Name or Nickname printed at the top of the badge. Title *This field is required. Registration Total Previous Next You may add as many prizes as you wish. If you are giving away multiple items of the same type, please add a line for each. We wish to donate the following items for door prizes: PrizeThis field is required. Add Remove Registration Total Previous Next Payment Pay by Check Pay by Credit Card Payment MethodThis field is required. Payment ReceivedThis field is required. Primary Contact *This field is required. Company *This field is required. Address Line 1 *This field is required. Address Line 2This field is required. City *This field is required. StateSelect...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingThis field is required. Zip *This field is required. Phone *This field is required. Email *This field is required. Confirm EmailThis field is required. Submit Credit or Debit CardThis field is required. Submit Payment Previous Registration Total GAHRA 2025 Annual Vendor Registration For questions or payments please contact: GAHRA Vendor Registration c/o Gary Erwin 607 Oothcalooga St Calhoun GA, 30701 email: gerwin@calhounha.org Telephone: (706) 629-9183 ext 12 You have been registered for this conference. Please print this page as receipt of your registration. Charge ID:
