JANE FLOYD & ASSOCIATES ACR Winter Rheumatology Symposium - January 23 – 29, 2016 – Viceroy Snowmass Please select the lift ticket option with special pricing available during your stay in Snowmass! Lift tickets are valid on all mountains, Buttermilk, Aspen Mountain, Aspen Highlands and Snowmass. Tickets are valid from January 20 – February 2, 2016. Multiple day ticket DOES NOT need to be used in consecutive order. Tickets must be ordered no later than January 3, 2016 for special discount pricing SENIOR (age 65) CHILD (age 7 – 12) ADULT TICKETS PRICING TOTAL SINGLE DAY - $80.00 __ Number Needed SINGLE DAY - $105.00 __ Number Needed $________ TWO DAY - $106 __ Number Needed TWO DAY out of 10 - $178.00 __ Number Needed $________ THREE DAY - $159 __ Number Needed THREE DAY out of 10 - $267.00 __ Number Needed $________ FOUR DAY - $212 __ Number Needed FOUR DAY out of 10 - $284.00 __ Number Needed $________ FIVE DAY - $265 __ Number Needed FIVE DAY out of 10- $355.00 __ Number Needed $________ SIX DAY - $318 __ Number Needed SIX DAY out of 10 - $426.00 __ Number Needed $________ SEVEN DAY - $371 __ Number Needed SEVEN DAY out of 10 - $497.00 __ Number Needed $________ Please add a 5% Handling Fee for Credit Card Payment TOTAL $________ $________ PRIMARY ATTENDEE NAME: DAYTIME PHONE NUMBER ._________________________________________ ( ARRIVAL DATE____________________________ CELL PHONE NUMBER STAYING AT_______________________________ ( )____________________ )____________________ E-MAIL ADDRESS__________________________ PAYMENT METHOD (check one) ___ CHECK ___ VISA ___MASTERCARD Credit Card No______________________________ Expiration Date___________ NAME ON CREDIT CARD (please print) AUTHORIZATION: By submitting this form, you are authorizing Jane Floyd & Assoc. to charge each “Total Amount” for activity fees (above) to the Credit Card number provided and confirming that the fees are non-refundable. ___________________________________________ CARDHOLDER SIGNATURE _________________________________________ Your tickets will be provided at check-in at the Front Desk of the property at which you are staying. ALL TICKETS ARE NON-REFUNDABLE Post Office Box 5843, Snowmass Village, Colorado 81615 970-923 -2333 jfloyd@janefloydassociates.com