School Alumni Chapters

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  • 2014 UMMC Medical Alumni Chapter Family Sunset Bay Cruise
    2014 UMMC Medical Alumni Chapter Family Sunset Bay Cruise

    MSMA Sunset Cruise 2014 Registration

    Please fill out the following form to register.
  • To assure availability, please register by May 20, 2014.

    First Name*
    Last Name*
    City, State, Zip Code*
    Home Phone()--
    Bus. Phone()-- ext.
    Cell Phone()--
    Hotel/Condo at MSMA
    Enjoy a sunset cruise with family and UMMC alumni and friends as you relax with appetizers, beverages, and possible dolphin sightings over the crystal blue waters of Destin Bay.
    I will attend the Medical Alumni Chapter dinner/cruise.
    Adults (18 years or older):
    Youth (12-17 years of age):
    Children under 12 years of age:
    @$25 per person =
    @ $10 per person =
    - FREE
    Spouse/Guest Name
    Child(ren)'s Name(s)
    Billing Information
    Total Amount Billed:

    Credit Card Information

    Please use Visa or Mastercard only.
    Card Holder Name*
    Card Type*
    Credit Card Number*
    Credit Card Expiration Date*
    Credit Card CVV Number*
    Located on the back of the card