JULY 2016 Event Registration Form Fax, Mail or deliver to: Golden Opportunity Ochsner Health System 1000 Ochsner Boulevard Covington, LA 70433
Golden Opportunity
985 875-2785 (fax),
[email protected]
NAME:
Phone:
Address:
City, State, Zip:
Important 1. 2. 3. 4. 5. 6.
Notes: Please send in whole reservation form (do not cut strips). Extra forms will be available at group meetings or you can pick up a form in the GO office. If you wish to register for an event requiring a fee, please check availability before submitting a check. Please note all fees are nonrefundable. Be sure to have your emergency and health info with you for all events. If an event requires payment by check please submit separate checks for events unless otherwise stated. Ochsner GO has the right to limit all program activity participation to members only. All GO events are subject to change and GO has the right to adjust events without formal notice.
COFFEE WITH CHRISTIE: Wednesday, July 6 – 10.00 a.m. (Ochsner Health CenterCovington, 2nd floor training room) RSVP REQUIRED! □ attend □ will not attend COFFEE WITH CHRISTIE: Thursday, July 7 – 9:30 a.m. (Ochsner Medical CenterNORTH SHORE, 100 Medical Center Drive, Slidell, Camellia Room) RSVP REQUIRED! □ attend □ will not attend
PRYTANIA THEATRE: Wednesday, July 13 (Covington pickup only) RSVP REQUIRED! □ attend
□ will not attend
□ add to wait list
LUNCH AND LEARN “I’ll Have It My Way”: Tuesday, July 19 - 11:30 a.m. to 1:00 p.m. (Ochsner Health Center-Covington, 2nd Floor Training Room.) RSVP REQUIRED! □ attend □ will not attend
LUNCH AND LEARN “Stroke and Stroke Prevention”: Thursday, July 21 - 11:30 a.m. to 1:00 p.m. (Ochsner Medical Center-NORTH SHORE, 100 Medical Center Drive, Slidell, Camellia Room) RSVP REQUIRED! □ attend □ will not attend
