MEETING ADVANCE REGISTRATION

65th Annual Brenemann Lectures
September 11-14, 2008

Disney Paradise Pier® Hotel
1717 South Disneyland Drive
Anaheim, CA 92802
(714) 956-MICKEY (6425)

This form can not be submitted electronically. Please fill-out the form then print it and fax or mail the form depending upon your payment method.
Fax: (310) 533-1315
Mail: PO Box 4198, Torrance, CA 90510-4198

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Phone

Tuition Fee:

Before 8/8 After 8/8 Your Total
Physicians: Members of LAPS $500 $550 $
Physician Non-members $550 $600 $
Pediatric Residents. Hospital: $100 $125 $
Allied Health Personnel. Category: $250 $300 $
Physicians Emeritus with LAPS $125 $175 $
Round Table Sessions (No charge)
Fri. Session 1, 2, 3, 4 (enter number in box in oder of preference) 1. 2. 3.
Sat. Session 1, 2, 3, 4 (enter number in box in oder of preference) 1. 2. 3.

Discounted Disneyland® Tickets Tickets are valid 9/8/08 to 9/17/08. Tickets purchased using this form must be purchased by check in advance by 8/19 and will not be available for pickup until 6:00 pm, Thursday, September 11.
Discounted Disneyland® tickets may also be purchased online.
Ages 3-9 Ages 10+  
One-Day One-Theme Park $46 $56 $
One-Day Disneyland® Resort Park Hopper $71 $81 $
Two-Day Disneyland® Resort Park Hopper $88 $108 $
One-Day One-Theme Park Twilight Ticket (after 4pm) $35 $35 $

  TOTAL $

Please make checks payable to:
Los Angeles Pediatric Society and return to: PO Box 4198, Torrance, CA 90510-4198

For additional information, phone 310-540-6240 or 310-328-2036.

 

Hotel Registration

64th Annual Brenemann Lectures
September 11-14, 2008

Disney Paradise Pier® Hotel
1717 South Disneyland Drive
Anaheim, CA 92802
(714) 956-MICKEY (6425)

This form can not be submitted electronically.
SEND HOTEL REGISTRATION DIRECTLY TO HOTEL WITH PAYMENT.
PLEASE CONFIRM YOUR RESERVATION AT (714) 956-MICKEY.

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Accommodations requested    Number in party

Arrival:  Date 

Departure Info:

 

Rooms are available to registrants at the special rate of $159 (plus tax) per day single or double occupancy, plus resort fee of $10. These rates apply from September 8-16, 2008. Note: Special rates will be available only until August 19, 2008 or until all blocked rooms are taken. Once these rooms are taken, regular hotel rates will apply. WE RECOMMEND YOU MAKE RESERVATIONS FAR IN ADVANCE OF THE MEETING. The Los Angeles Pediatric Society disclaims any responsibility for hotel arrangements. Please make check payable and send to Disney Paridise Pier® Hotel 1717 South Disneyland Drive, Anaheim, CA 92802. Phone Number: (714) 956-MICKEY (6425).

NOTE: This billing is for HOTEL ONLY

Credit card:     Number Exp.


Signature ___________________________________________________________


Please make checks payable and send to:

Disney Paradise Pier® Hotel, 1717 South Disneyland Drive, Anaheim, CA 92802

Phone Number: (714) 956-MICKEY (6425)