USI Elite Consultant Event Registration Form

Elite Broker Celebration Registration Form

To register as an attendee for the USI Elite Broker Celebration in Sarasota, FL, on April 7-9, please fill out the form below. If you have any questions, contact Katie Volpentesta at katie.volpentesta@lucenthealth.com.

Personal Information

Name
Email Address
Office Location
Phone Number

Travel Details

How are you traveling to Sarasota?
Arrival Date
Departure Date
Are you bringing a plus one?
If yes, please list their name and email.
Will you need a hotel room?
If yes, please check the boxes for the evening(s) you'll need hotel accommodations for.
If you have already booked your flight, insert your flight details here (ex: flight departure and arrival time, confirmation/receipt).

Note: Please submit receipts here or email them to Katie Volpentesta to ensure that you receive a reimbursement check at the event.

Other Details

Are you interested in golf or a trip to the spa?
If you'd like to golf with the Lucent Health and USI teams, please indicate which tee times you are available for.
Do you need rental clubs?
If you'd like to enjoy a massage or facial instead of golf, please indicate which to book and which times work best for you.
Please list any allergies, dietary restrictions, or ADA accommodations you may need:
What is your preferred polo size?
If you have any questions or comments, please leave them here. A member of the Lucent Health team will reach out shortly to help answer any questions you may have.