REGISTRATION/DONATION FORM

Early Bird Special - 10% off (Register before 05/31/2018)  Group Discounts - 15% Off (More than 10 People in single Registration)


Personal Details


Registration Package
Package Description Ticket Cost No.of Tickets Total
R001 Single Adult (Age 24 to 64) $150
R002 Children (Age 7 to 15) $75
R003 Youth (Age 16 to 23)/ **Student $100
R004 **Senior Citizen (Age 65 and above ) / Visitor $100
R005 CME $125
R006 NATA Lifetime Membership(50% Discount) $50

* Information is mandatory.


**A valid photoId is required for Students / Seniors citizens or Visitors and will be verified at the venue.

Children under 6 Years are free to enter the event.

Total Amount($):


Donation Package(See Benefits)
Package Description Donation Range Amount
 D001 Royal Sponsor $100,000 +
 D002 Grand Sponsor $50,000 - $99,999
 D003 Grand Donor $25,000 - $49,999
 D004 Grand Benefactor $10,000 - $24,999
 D005 Benefactor $5,000 - $9,999
 D006 Grand Patron $2,500 - $4,999
 D007 Patron $1,000 - $2,499

*** Complimentary NATA lifetime membership is included to $ 1,000 or more donors, only if they are not already NATA Members.

Grand Total($) : [Including Discount]
I DECLARE that I have read and understand the package information, Terms and Conditions provided.
I AUTHORIZE the charges provided in the payment section.
I AGREE all Registrations / Donations are final and no refunds/ Exchanges / Cancellations will be accepted.
I AGREE all Terms and conditions of NATA Lifetime Membership.