2023 Company Picnic - FLYING W RANCH

2023 Company Picnics

The Flying W Ranch

Colorado Springs, CO

July 15, 2023

We are excited that you are interested in joining our company picnic! We offer this to you and your family to enjoy a day of fun so you can spend time with your family, meet your coworker’s families, and know that you are valued and appreciated for all of your hard work. Picnics are our way of saying thank you for your commitment to Miller Pipeline/KR Swerdfeger and our team.

Carefully read all of the details, RSVP form, and other upcoming communications for each picnic to ensure you are ready and feel prepared for the event.

To register, please fill out the details in this form carefully, and you will receive a confirmation email upon submission. For any questions, please reach out to corporate.communications@millerpipeline.com.

Personal Information

Name*

First Name

Last Name

Email*

SUBMIT AN EMAIL THAT IS REGULARLY CHECKED. THIS IS WHERE ALL PICNIC COMMUNICATIONS WILL GO.

Phone*

What regional office do you report to?*

Who is your supervisor/superintendent?*

What is your job title?*

If other, please specify.*

Employee T-shirt Size*

Family Member Attendance

A family member includes anyone you claim on your W2 or who lives in your current household. If your child uses a seat when they are eating, they need to be counted in your family guest attendance (the standard for this is 2 and above).

Including yourself, how many family members will be attending?*

Are you sure you do not want to attend and would just like a shirt?*

Yes, I do not want to attend a picnic but I would still like a shirt.

Family Member #1's First and Last Name*

First Name

Last Name

Family Member #1's Age*

Family Member #1's Relationship to Employee*

Family Member #2's First and Last Name*

First Name

Last Name

Family Member #2's Age*

Family Member #2's Relationship to Employee*

Family Member #3's First and Last Name*

First Name

Last Name

Family Member #3's Age*

Family Member #3's Relationship to Employee*

Family Member #4's First and Last Name*

First Name

Last Name

Family Member #4's Age*

Family Member #4's Relationship to Employee*

Family Member #5's First and Last Name*

First Name

Last Name

Family Member #5's Age*

Family Member #5's Relationship to Employee*

Family Member #6's First and Last Name*

First Name

Last Name

Family Member #6's Age*

Family Member #6's Relationship to Employee*

Family Member #7's First and Last Name*

First Name

Last Name

Family Member #7's Age*

Family Member #7's Relationship to Employee*

Family Member #8's First and Last Name*

First Name

Last Name

Family Member #8's Age*

Family Member #8's Relationship to Employee*

Family Member #9's First and Last Name*

First Name

Last Name

Family Member #9's Age*

Family Member #9's Relationship to Employee*

Family Member #10's First and Last Name*

First Name

Last Name

Family Member #10's Age*

Family Member #10's Relationship to Employee*

Family Member #11's First and Last Name*

First Name

Last Name

Family Member #11's Age*

Family Member #11's Relationship to Employee*

Family Member #12's First and Last Name*

First Name

Last Name

Family Member #12's Age*

Family Member #12's Relationship to Employee*

Guest Attendance

Anyone who does not fall under the family parameters will be considered a guest. Each guest ticket will cost $72.75. If your guest is a child and uses a seat when they are eating, they need to be counted in your family guest attendance (the standard for this is 2 and above). This includes dinner and a show.

How many guest tickets would you like to purchase?*

Guest Ticket Price Total

Family/Additional T-Shirts

All employees will receive a free company picnic t-shirt. If you want to purchase additional shirts for you or your family, each additional t-shirt will cost $6.

Not including your employee shirt, how many family/additional shirts would you like to purchase?*

T-shirt #1 Size

T-shirt #2 Size

T-shirt #3 Size

T-shirt #4 Size

T-shirt #5 Size

T-shirt #6 Size

T-shirt #7 Size

T-shirt #8 Size

T-shirt #9 Size

T-shirt #10 Size

T-shirt Purchase Total

Grand Total

Guest Tickets Total + T-Shirt Purchase Total = Grand Total

Grand Total

Credit Card Information

Credit Card

Terms and Agreements

By marking this box, I understand and agree that there will be no refunds issued for shirts or guest tickets.*

Yes, I understand and agree.

By marking this box, I understand and agree that I have RSVPed for all family members and guests that will be attending the picnic. Tickets will not be available after the RSVP date.*

Yes, I understand and agree.

Photo and Video Use Consent: By marking this box, I hereby grant my full and irrevocable consent to the creation, use, reproduction, airing, or publication by Miller Pipeline for educational, commercial, training and/or any other purpose including, but not limited to, advertising and publicity in any geographical location of any and or all portions of the photographs, video, audio or published materials in which I may appear and assign and transfer to Miller Pipeline, all rights, interest and title to all audio, published comments, or video/film reproductions, including but not limited to proofs, prints, photographs, films, or videotape taken of parties to this agreement or on their behalf by any other third party.*

Yes, I understand and agree.