Lonestar Attendee Form with Payment

Lonestar 2026 Attendee Roadshow Registration
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Format: (000) 000-0000.
Insurance License#*
NABIP Chapter Name*
Plan to attend the golf outing, check here
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Payments are processed through Square. You may pay using any major credit card / debit card. Please note, there is a 4% processing fee for card usage. The below rates change on April 15, 2026 to: Members $80 / Non-Members $100

My Products

Roadshow Entry (member)

$50.00

Roadshow Entry (non-member)

$80.00

Member Agency Office

5 attendees from the same Agency

$220.00 Quantity

Member Agency Additional above 5 attendees, Per person

$44.00 Quantity

Attending Golf Suites Outing

$ Free Quantity

Non-Member Agency Office

$444.00 Quantity

Non-Member Additional Over 5

$74.00 Quantity

Total

$0.00

Lonestar 2026 Attendee Roadshow Registration