Convention Registration Form - Oregon DeMolay

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Convention Registration Form

Home » Events Calendar » Convention Registration Form

Each attendee must fill out a separate registration form.

"*" indicates required fields

Step 1 of 2

50%

Hidden

Event*

Registration for a:*

Youth

Adult

Name*

First Last

Address*

Street Address City State ZIP Code

Phone*

Email*

Shirt Size*

Organization Affiliation

Youth Registration

Age*

Release and Consent Forms

Click the buttons below to download blank forms; then upload your completed forms to attach to this registration.

Photo Release Form Medical History and Release Form

Upload Forms*

Attach completed Medical Release and Photo Release forms

Drop files here or

Accepted file types: pdf, Max. file size: 256 MB.

Select Title below:

DeMolay (Your Title)

Member

State Officer

Sweetheart

International Officers

N/A

Job’s Daughters (Your Title)

Member

State Officer

International Officer

N/A

Rainbow (Your Title)

Member

State Officer

International Officer

N/A

Youth Jurisdiction

Oregon

Other

Who will be your responsible advisor or chaperone?

The chaperone must be a trained advisor of your youth organization or an immediate relative.

Requested Roommate(s):

We will do our best to accommodate requests, but priority is compliance with DeMolay International Youth Protection Rules.

Adult Registration

Title

Advisor

Chaperone

Executive Staff

Event Staff

Alumni

Guest

Release and Consent Forms

Click the buttons below to download blank forms; then upload your completed forms to attach to this registration.

Photo Release Form Medical History and Release Form

Upload Forms*

Attach completed Medical Release and Photo Release forms

Drop files here or

Accepted file types: pdf, Max. file size: 256 MB.

Fees

Youth Registration Fees:*

Please make a housing selection below. (Oregon DeMolay members receive a $125 Rodger Rees scholarship.)

$250.00 - Registration, 4 Per Room: Oregon DeMolay Only

$350.00 - Registration, 2 Per Room: Oregon DeMolay Only

$375.00 - Registration, 4 Per Room: Non Oregon DeMolay, Sweethearts, and other youth

$475.00 - Registration, 2 Per Room: Non Oregon DeMolay, Sweethearts, and other youth

Adult Registration Fees:*

Please select the appropriate line for housing selection

$475.00 - Registration, 2 Per Room: All Chaperones, Advisors, and other adults

$775.00 - Registration, 1 Per Room: All Chaperones, Advisors, and other adults

Confirm Fees:*

Confirm fees above

Enter a custom payment amount

Custom Amount:

Adjustment:

Price: $0.00

Updating your total to equal custom amount.

Promo Code:

Total Ad Sales:

Ad Sales Discount:

70% of ad sales may be applied to your convention fees.

Price: $0.00

Total:

To pay another amount, click here to make a custom payment

Comments/Questions:

Do you have any food restrictions or allergies we should be aware of? Any other notes about your registration?

Make a Payment: Click PayPal button below. Your registration will be submitted when payment is complete.

Payment Method

Click PayPal button or select Credit Card option below. Your registration will be submitted when payment is complete.

MasterCard

Visa

Supported Credit Cards: MasterCard, Visa

Card Number Expiration Date Security Code Cardholder Name

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