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JCDA State Convention Online Registration

- June 30 - July 2, 2023 Round Rock, TX
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  Court Contact Information:
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Return Receipt Email REQUIRED Please fill out this field. Please enter an email address.
  
  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.
  
  Registration
  You may register all attendees from your court. First enter the number of attendees and the form will expand. Then enter registration information for each attendee.
  
  Enter Number of Attendees REQUIRED Please fill out this field.
  
  Attendee No. 1
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 2
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 3
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 4
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 5
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 6
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 7
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 8
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 9
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 10
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 11
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 12
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 13
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 14
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 15
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 16
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 17
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 18
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 19
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Attendee No. 20
  
  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 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.
  
  Name on Name Tag REQUIRED Please fill out this field. Please enter valid data.
  
  Attendee Roles (check all that apply): Junior Member Delegate Junior Member Alternate Junior Member Juniorette Member JCDA Chairman CDA State Officer CDA State Chairman CDA Member Guest
  
  Age REQUIRED Please fill out this field.
  
  Registration:
  
  Registration Fee pays for the following: Registration, Friday Night Movie and Dance Party, Banquet Meal and Convention T-Shirt.
  
  Kindly note:
  1) Registration fees are non-refundable.
  2) Late registration will apply after May 23, 2023: $120 for entire convention.
  
  Registration REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Purchase additional banquet tickets:
  
  Extra Banquet Tickets50.0
  
  Quantity of Extra Banquet Tickets Maximum 5 characters
  Quantity is for your guests.
  Please enter an integer (number) from 0 to 5.
  
  Total:
  
  Submit
  
  Proceed to Payment
  
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Questions?
- Convention Registration Chair: Email Laura Caruso
  Online Registration Help: Email Suzanne Delcambre
  
  See y'all in Round Rock!
- Would you rather register with a printed form? Download the JCDA Call to Convention & Registration Form