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PERSONAL INFORMATION               REGISTER >>    Child   


First Name      MI        Last Name
      
Type first name as desired for name badge (i.e. ROB, JOE) 

Kiwanis Club   
      
Current Club, Division or District Office Held      
      Are you a delegate?      no             yes


 CONTACT INFORMATION

Street
      
City       State     Zip

Contact Phone                   Email          


 SPOUSE  INFORMATION   

 If you are registering your spouse, enter his/her information below

Is your spouse a Kiwanian    No      Yes             Delegate?      no yes

First Name       MI        Last Name
      
Type first name as desired for name badge (i.e. Joe, Joseph)

Kiwanis Club   
Current Club, Division or District Office Held       


* SELECT PACKAGES *

 PACKAGE 1 

 INCLUDES:          $180/ Person        $335/couple [ YOU SAVE $25! ]   

 Registration Fee, Program Book, Name Badge
    
 All Educational Forums & House of delegates.

      
MEALS & ENTERTAINMENT                    

 Friday Luncheon        Saturday's Banquet
 Friday Night Entertainment  
 Saturday Luncheon    Sunday Breakfast

COUPLE REGISTERING TOGETHER, Check to Save an additional $25.00 >>>>

  - QUANTITY                                             A LA CARTE MEALS & ACTIVITIES
 
  
 
 
 PACKAGE 2 

      $100              

Includes: 
Convention Registration Fee, Program Book, Name Badge, and speakers.

All Educational Forums and Saturday House of Delegates.  
Meals & Friday Night Entertainment are NOT included in this package.
 Tickets may be purchased separately.

  - QUANTITY                                              A LA CARTE MEALS & ACTIVITIES 
                          

    
     

  FRIDAY NIGHT ENTERTAINMENT

Dennis Swanberg "The Swan"... is considered by many as "AMERICA'S MINISTER OF ENCOURAGEMENT". He uses laughter as a tool to break down people's barriers about themselves and promotes faith and family values in a lighthearted and humorous way. He has the reputation of instilling hope and motivating people from all walks of life.

Dr. Swanberg has been featured on the world-wide radio ministry of Dr. James Dobson's "Focus on the Family". He has spoken in many denominations and churches throughout the country and is the host of the weekly variety show "Swan's Place" aired nationwide, and the new "Dennis Swanberg Show", also seen weekly nationwide on the Trinity Broadcasting Network.

Ticket is included in package 1. 
If you chose package 2, be sure to purchase a ticket for "Dennis Swanberg"
- It's Package 5 in the A La Carte Menu.
     
For more information visit:   www.dennisswanberg.com
 

 
                        A LA CARTE MEALS & ACTIVITIES                          

REQUIRES PURCHASE OF PACKAGE 1 OR 2 EXCEPT YOUTH MEALS
(3) $25.00   Friday Past Governors' Breakfast
  (for Past Governors & Spouses only) MUST REGISTER.		 qty
(4) $30.00   Friday Interclub Luncheon   (Ticket included in Package #1) qty
(5) $10.00  Friday Night Entertainment "Dennis Swanberg"
  -AMERICA'S MINISTER OF ENCOURAGEMENT  (Tkt incl.  in Package #1)		 qty
(6) $25.00   Saturday Past Lt. Govs.' Breakfast (Past, current & 
   Incoming Lt. Governors & spouses only).  MUST REGISTER.		 qty
(7) $30.00   Saturday Interclub Luncheon    (Ticket included in Package #1) qty
(8) $40.00   Saturday Night Retirement and Installation Dinner
  (Ticket included in Package #1)		 qty
(9) $25.00   Sunday Memorial Breakfast   (Ticket included Pkg. 1) qty
     

 

Personal Information & Package Selection

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