The Rocky Mountain District of Key Club International presents: The 61st Annual District Convention, April 5th-7th, 2013 Sheraton Denver West Hotel Name of Registrant: _____________________________________Grade: _____ Division __________ Key Club of: __________________________________________ Office currently held: __________ Address: __________________________ City: _____________ State: _________ Zip: ____________ Phone: (___) ____-________ Email: ______________________________________________________ Adult Sponsor (Required): ____________________________________________________________ Emergency Contact: ______________________________________ Phone: (___) ____-_________ IMPORTANT, Please read the following: 1.
Use one form per attendee
2.
Appropriate payment, in full, must accompany this form. Additional arrangements can be made with the District Administrator.
3.
Any registration received after March 15th, 2013 will require a $15.00 late fee.
Cancelation Policies: 1.
2.
All cancelations must be made in writing on or before March 22nd, 2013 to ensure a complete refund. Any cancelation received after this date is subject to a $50.00 penalty. NO refunds will be granted after March 29th, 2013.
Registration Fees: 1.
Adults may have single or double rooms ONLY. Desired Roommates: 1.
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2.
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3.
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Meals: Saturday K-family Luncheon Meal options: (Check one.)
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Beef
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Fish
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Pasta (vegetarian)
Check the following that apply. I am:
Registration includes: 2 nights of lodging, convention shirt, entertainment (including a talent show that YOU can star in), a dance, key note speaker, workshops, and 2 meals (K-family Luncheon and Farewell Brunch)
___ Male
___ Female
___ Key Clubber
___ Advisor
___ Parent
___ Builders Club
___ Other, Please specify _______________________
Rooming Arrangements: If no rooming specified, registrant will be placed in a quad; each price is per registrant. (Check one.)
If you are not attending for the full weekend, just for the luncheon or brunch, check one of the following and list how many seats you would like to reserve. ___Saturday, K-family Luncheon $35.00 per person
___Quad: $210 ___Double: $255
___Triple: $225 ___Single: $345
All FRESHMEN students are awarded a 10% discount on quad occupancy rooms. The price per freshman registrant is $189.
___ Sunday, Farewell Brunch $30.00 per person Total amount enclosed: $ ______________________ Send form to: David Harris, RMD District Administrator, RMDKCAd@aol.com or send them to 1641 S. Parfet Ct. Lakewood, CO, 80232. If you any questions, feel free to call Noha Kikhia, Convention Chair, nkikhia.conventionchair@gmail.com. 720.438.8000, or David Harris at 720.341.5064
I, as a member of the RMD Key Club, agree to abide to the Key Club Code of Conduct, if I do not abide by the rules I understand that I can be excluded from this convention. Student Signature _____________________________ Parent / Guardian Signature ____________________________
For more information on District Convention visit rmdkeyclub.org or join the 2013 RMD Key Club Convention Page on Facebook.
I, as a member of the RMD Key Club, agree to abide to the Key Club Code of Conduct, if I do not abide by the rules I understand that I can be excluded from this convention. Student Signature _____________________________ Parent / Guardian Signature ____________________________