October 2016 Event Registration Form Mail or bring to: Golden Opportunity
Golden Opportunity
1401 Jefferson Highway New Orleans, LA 70121 504-842-7000 NAME:
Home Phone: ___________________________ Cell Phone: _____________________________
Address:
City, State, Zip:
Important Notes: Effectively Immediately 1. 2.
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Please send in the Event Registration Form with your payment. All prices are listed are per person. If you register to attend an event, please note that all events will be NONREFUNDABLE (includes the ($5) Ochsner bus fee). If someone is on the waiting list, and you contact the office in advance of the event. We’ll make every effort to have that person’s payment reimbursed to you. A credit will no longer be issued. If an event requires payment by check, submit separate checks for each event unless you are paying for more than one person for the same event. Please put the event name on the bottom of the check as some events have the same cost. Please SIGN your check. When attending “LUNCH BUNCH” please be prepared that this event will not return to the Primary Care & Wellness Center until event is over (approximately 2:30 p.m.). Please do not sign-up for this event if you have “Schedule Conflicts”!
October 3rd (Monday): Lunch Bunch – Gattuso’s Restaurant (Gretna) “On Your Own” $5.00 per person (Ochsner bus fee) Departure: 10:15 a.m. – Ochsner Hospital River Road Entrance □ attend □ will not attend October 4th (Tuesday): Members’ Monthly Meeting 10:00 a.m. – 11:30 a.m. – Brent House – Caldwell & LeJeune Rooms Light refreshments provided! □ attend □ will not attend October 5th (Wednesday): Oktoberfest (Helen, GA) October 16-21, 2016 Trip Meeting For those members not attending Oktoberfest, the office will be staffed by volunteers Monday – Friday (limited hours) 10:00 a.m. – 11:30 a.m. – Center for Primary Care & Wellness - Camellia Room Light refreshments provided! □ attend □ will not attend October 7th (Friday): Dempsey’s Seafood & Steak Restaurant, Kiln, MS & Shopping in Old Bay Town, Bay St. Louis $26.00 per person (includes motorcoach transportation only, lunch “on your own”) Departure: 10:15 a.m. – Ochsner Hospital River Road Entrance □ attend □ will not attend October 19th (Wednesday): 2017 Insurance Updates – Senior Health Insurance Information Program (SHIIP) Presented by: SHIIP Representative 10:00 a.m. – 11:30 a.m. – Center for Primary Care & Wellness - Camellia Room Light refreshments provided! □ attend □ will not attend
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October 2016 Event Registration Form Golden Opportunity NAME:
Home Phone: ___________________________ Cell Phone: _____________________________
Address:
City, State, Zip:
October 25th (Tuesday): 2017 Insurance Updates – Peoples Health Network (PHN) Presented by: Christy Levy, Representative 9:00 a.m. – 12 noon – Brent House – Caldwell/LeJeune Rooms □ attend □ will not attend October 26th (Wednesday): 2017 Insurance Updates – Humana Presented by: Carmelitta Favorite, Representative 10:00 a.m. – 11:30 a.m. – Center for Primary Care & Wellness - Camellia Room Light refreshments provided! □ attend □ will not attend October 28th (Friday): Golden Opportunity New Region Kick-off - St Charles Parish RSPV Ann Laiche, GO Program Coordinator – 504-464-2974 (Kenner Office) or 985-224-1253 (LaPlace Office)
October 31st (Monday): Members’ Halloween Potluck (Bring a dish, wear your costume and socialize with other members) 12:00 p.m. – 1:30 p.m. - Brent House – LeJeune Room □ attend □ will not attend
All GO events are subject to change. Ochsner Golden Opportunity has the right to adjust events without formal notice. All events are non-refundable (includes the $5.00 Ochsner bus fee). If there is someone on the waiting list to take your place, that person will make their check payable to you and the check will be mailed to you via Golden Opportunity. Golden Opportunity has to guarantee payment to vendors for most events.
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