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 3

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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*

Select Jurisdiction & Title below:

DeMolay

Member

State Officer

Sweetheart

International Officers

Job’s Daughters

Member

State Officer

International Officer

Rainbow

Member

State Officer

International Officer

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

Jurisdiction

Title

Advisor

Chaperone

Executive Staff

Event Staff

Alumni

Guest

Release and Consent Forms

Upload completed forms to attach to this registration.

Photo Release Form

Medical History and Release Form

Upload Forms*

Attach completed Medical Release & Photo Release forms

Drop files here or

Accepted file types: pdf, Max. file size: 256 MB, Max. files: 2.

Fees

Youth Registration Fees:*

Please make a housing selection below. *Early Registration ends December 31st.

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

$475.00 - Registration, 2 Per Room: All 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

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Promo Code

Pay 50% now with Promo Code payhalf and the remainder by April 1, 2023. No refunds on registrations. Early Registration ends December 31st.

Total

Comments/Questions:

Do you have any food restrictions or allergies we should be aware of?

Payment Method

MasterCard

Visa

Supported Credit Cards: MasterCard, Visa

Card Number Expiration Date Security Code Cardholder Name

Phone

This field is for validation purposes and should be left unchanged.

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P.O. Box 66214, Portland, OR 97290

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