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Registration
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Registration Form
Register
Email Address
First Name
Last Name
Phone Number
Which division are you in?
Please select a Division
A-Team
Aviators
Banville Division
Producers
Ring Team
Alpha Omega Financial
Manhattan Life (Premier Sponsor)
LifeX (Platinum Sponsor)
Philadelphia American Life (Platinum Sponsor)
Allstate (Gold Sponsor)
Amerilife (Gold Sponsor)
Med Mutual Pro (Gold Sponsor)
CVS Health-Aetna (Silver Sponsor)
American Amicable Group (Silver Sponsor)
Americo (Silver Sponsor)
Enrollment FIrst (Silver Sponsor)
Population Science Management (Silver Sponsor)
Mutual of Omaha (Silver Sponsor)
Will you attend?
Please let us know if you are attending
Yes I will be attending
No I will not be able to make it
You're welcome to bring guests/family to the event.
# of Guests (in addition to yourself)
Umbrella and Chair Rentals
We are renting a limited number of umbrellas and chairs. Each set comes with an umbrella and 2 lounge chairs. Would you like us to reserve a set for you?
Please reserve an umbrella and 2 chairs
Photo and Video Release Policy
By attending this event, you grant USA Benefits Group and its authorized representatives the right to take photographs and video recordings of you during the event. These images and recordings may be used in promotional materials, publications, social media, and other media formats—now or in the future—without compensation or further approval. Your participation signifies your consent to be photographed and/or recorded and to the use of your likeness, image, and voice as described above. If you do not wish to be photographed or recorded, please notify a member of the event staff upon arrival. Thank you for being a part of this experience and helping us capture the celebration!
I agree to the Photo and Video Release Policy
Submit