HiddenEvent Dates HiddenComplimentary Room Date HiddenPayment Due Date HiddenRegistration Manager HiddenRegistration Manager Email Register For:* Deluxe Individual - $925.00 Deluxe Couples - $1395.00 Standard Individual - $475.00 A la Carte # of A la Carte Attendees*Please enter a number from 1 to 4.Attendee InformationAttendee #1Name* Prefix Dr.MissMr.Mrs.Ms.Prof.Rev. First Last Suffix Company / Organization Leader of Colorado Donor or Higher ($150 or higher)?* Yes No Leader of Colorado Discount Code*With your code, you will receive 5% off the total of your Retreat Registration costs. If you have not received your code, please call 303.488.0018. President's Club Level Donor or Higher?*President's Club Level Donors or Higher receive an additional discount on PLUGin tickets equivalent to $10 off the $75 per ticket price in addition to your 5% off the total registration price. Yes No LPR or RLP Alumni?* Yes No Graduation Year?*19891990199119921993199419961998200020012002200320042005200620072008200920102011201220132014201520162017201820192020Purchase Plug-In Event Tickets?*Tickets are $75.00 each One Ticket Two Tickets None HiddenVIP Reception* Yes $350.00 No Friday Dinner* Yes $325.00 No Saturday Lunch* Yes $250.00 No Sessions* Yes $295.00 No Attendee #2 InformationName* Prefix Dr.MissMr.Mrs.Ms.Prof.Rev. First Last Suffix Company / Organization LPR or RLP Alumni?* Yes No Graduation Year?*19891990199119921993199419961998200020012002200320042005200620072008200920102011201220132014201520162017201820192020Purchase Plug-In Event Tickets?*Tickets are $75.00 each One Ticket Two Tickets None HiddenVIP Reception* Yes $350.00 No Friday Dinner* Yes $325.00 No Saturday Lunch* Yes $250.00 No Sessions* Yes $295.00 No Attendee #3 InformationName* Prefix Dr.MissMr.Mrs.Ms.Prof.Rev. First Last Suffix Company / Organization LPR or RLP Alumni?* Yes No Graduation Year?*19891990199119921993199419961998200020012002200320042005200620072008200920102011201220132014201520162017201820192020Purchase Plug-In Event Tickets?*Tickets are $75.00 each One Ticket Two Tickets None HiddenVIP Reception* Yes $350.00 No Friday Dinner* Yes $325.00 No Saturday Lunch* Yes $250.00 No Sessions* Yes $295.00 No Attendee #4 InformationName* Prefix Dr.MissMr.Mrs.Ms.Prof.Rev. First Last Suffix Company / Organization LPR or RLP Alumni?* Yes No Graduation Year?*19891990199119921993199419961998200020012002200320042005200620072008200920102011201220132014201520162017201820192020Purchase Plug-In Event Tickets?*Tickets are $75.00 each One Ticket Two Tickets None HiddenVIP Reception* Yes $350.00 No Friday Dinner* Yes $325.00 No Saturday Lunch* Yes $250.00 No Sessions* Yes $295.00 No HiddenTotal AmountTotal Billing InformationName* Prefix Dr.MissMr.Mrs.Ms.Prof.Rev. First Last Suffix Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Company or Organization Email* Enter Email Confirm Email Phone*How Did You Hear About the Retreat?*EmailFacebookLPR AlumniRoss Kaminsky ShowRadio AdvertisementFriends/FamilyCaucusRoomOtherOther* Payment OptionsPayment Options* Credit Card Online Mail-in Check or Money Order Credit Card* DiscoverMasterCardVisaSupported Credit Cards: Discover, MasterCard, Visa Card Number Expiration Date Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Security Code Cardholder Name Please be sure to mail your check or money order to: Leadership Program of the Rockies 1777 South Harrison Street, Suite 807 Denver, CO 80210 Click submit to complete your registration pledge. Please note, where spots are limited, places cannot be reserved until payment is received in full.
