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2023 Convention Online Registration

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  It's ISLAND TIME!
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Maximum 35 characters Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Court Name REQUIRED Please fill out this field. Please enter valid data.
  
  Court Number REQUIRED Please fill out this field. Please enter valid data.
  
  Court City REQUIRED Please fill out this field. Please enter valid data.
  
  District Number REQUIRED Please fill out this field. Please enter valid data.
  
  Registration (Nancy Zureck, Chairman)
  
  Name for Name Tag Please enter valid data.
  
  Title for Name Tag Please enter valid data.
  
  Additional Information for Name Tag(check all that apply) REQUIRED Delegate Alternate Court Member Spouse First Timer Guest Please fill out this field.
  
  Additional Information:
  Let us know any special instructions:
  
  A. Registration — No Registration Fees are required for chaplains, spouses and/or guests attending the Convention. All fees for CDA members attending the convention are non-refundable. **Late registration will apply after March 15, 2023: $105 for entire convention, $75 for One Day Registration) **
  
  B. CDA Commemorative T-Shirt — INCLUDED IN THE REGISTRATION FEE FOR THE ENTIRE EVENT (Not guaranteed with late registration.)
  
  A. Registration REQUIRED Please fill out this field.
  
  B. T-Shirt Size - No Cost with Entire Convention Registration
  
  Meal Selections (Duchess Collins, Chairman)
  
  Most Blessed Are You Luncheon – Friday (Early Bird)65.0
  
  Note: This event was formerly called the Men's/Clergy lunch, not intended for CDA members.
  
  Quantity Most Blessed Are You Luncheon tickets: Maximum 5 characters
  Quantity is for your guests.
  Please enter an integer (number) from 0 to 5.
  
  Escape to Pink Paradise -Friday Evening (Early Bird)70.0
  
  Quantity Escape to Pink Paradise tickets: Maximum 5 characters
  Quantity is for your guests.
  Please enter an integer (number) from 0 to 5.
  
  Appreciation Banquet – Saturday Evening (Early Bird)75.0
  
  Quantity Appreciation Banquet tickets: Maximum 5 characters
  Quantity is is number of tickets for you and your guests.
  Please enter an integer (number) from 0 to 5.
  
  Appreciation Banquet Special Dietary Needs
  Review the menu below to determine if you will need a special plate. Example: “Diabetic. Need sugar free dessert or fresh fruit.”
  
  Saturday Appreciation Banquet Menu
  
  6 oz. Beef Filet & 4 oz. Gulf Red Snapper
  
  Spinach & Roasted Pear w/Candied Pecans & Sweet Onion Confit w/Red Wine-Dijon Vinaigrette
  
  Chocolate Truffle Cake – Chocolate Flourless Cake w/Vanilla Custard Sauce & Seasonal Berries
  
  Dietary Concerns (please describe here): Maximum 65 characters Please enter valid data.
  
  Please note: Late meal fees apply after 3/15/23: “Most Blessed Are You” Luncheon – Friday $75.00, Escape to Pink Paradise (Friday Evening) $80.00, Appreciation Banquet – (Saturday Evening) $85, Appreciation Banquet – (Dietary Meal) $85.00
  
  Walk /Run Registration (Mary Montague, Chairman)
  
  Sunrise "Flee the Flock" - Walk/Run
  
  Proceeds benefit
  Missions of Mercy (MOM) Projects
  (registration deadline March 1, 2023)
  
  Walk/Run Registration
  
  Walk Run T-Shirt Size
  
  Additional Donation to MOMS projects $ Please enter a positive decimal.
  
  Direct my additional donation to the following MOM project:
  
  Purchase Additional Convention T-Shirts
  
  Price per T-Shirt $10
  Request shirts by size:
  
  Small Convention T-Shirts10.0
  
  Small T-Shirts Maximum 9 characters
  For greater quantities, contact Cathy Bittner
  Please enter an integer (number) from 0 to 9.
  
  Medium Convention T-Shirts10.0
  
  Medium T-Shirts Maximum 9 characters
  For greater quantities, contact Cathy Bittner
  Please enter an integer (number) from 0 to 9.
  
  Large Convention T-Shirts10.0
  
  Large T-Shirts Maximum 9 characters
  For greater quantities, contact Cathy Bittner
  Please enter an integer (number) from 0 to 9.
  
  X-Large Convention T-Shirts10.0
  
  X- Large T-Shirts Maximum 9 characters
  For greater quantities, contact Cathy Bittner
  Please enter an integer (number) from 0 to 9.
  
  2X-Large Convention T-Shirts10.0
  
  2X- Large T-Shirts Maximum 9 characters
  For greater quantities, contact Cathy Bittner
  Please enter an integer (number) from 0 to 9.
  
  3X-Large Convention T-Shirts10.0
  
  3X- Large T-Shirts Maximum 9 characters
  For greater quantities, contact Cathy Bittner
  Please enter an integer (number) from 0 to 9.
  
  4X-Large Convention T-Shirts10.0
  
  4X- Large T-Shirts Maximum 9 characters
  For greater quantities, contact Cathy Bittner
  Please enter an integer (number) from 0 to 9.
  
  Online Processing Fee2.0
  
  Total:
  
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2023 Convention Online Registration

It's ISLAND TIME!