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Two Day Conference Registration

- The maximum number of form submissions has been reached. This form is currently not available.
  
  Which days do you plan to attend? REQUIRED Thursday (07/16) & Friday (07/17) Friday (07/17) & Saturday (07/18) Please fill out this field.
  
  Title
  
  Legal/Given Name
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mailing Address Line 1 REQUIRED
  i.e. 1234 First Street
  Please fill out this field. Please enter valid data.
  
  Mailing Address Line 2
  Apartment or Lot #
  Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Province (if applicable) Please enter valid data.
  
  Country (if outside U.S.) Please enter valid data.
  
  Primary Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Other Phone Number Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Sex REQUIRED Male Female Please fill out this field.
  
  Tribe/Nation Please enter valid data.
  
  Arch/Diocese Please enter valid data.
  
  Number of Emergency Contacts REQUIRED Please fill out this field.
  
  Emergency Contact 1
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Emergency Contact 2
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Medical Information (Optional)
  
  Will you need wheelchair assistance? Yes - I will bring my own Yes - I am requesting a wheelchair for on-site use No
  
  Photo/Video Release REQUIRED
  Tekakwitha Conference's legal representatives, videographers & photographers retain the rights and permission to publish without charge photographic and video content taken during this event. These images or videos may be used in publications, presentations, and promotional literature.
  Yes, I consent No, I do not consent Please fill out this field.
  
  Hotel/Lodging for Shuttle Service REQUIRED
  Complimentary airport shuttle service is being provided by the 2020 Planning Committee from the Raleigh-Durham International Airport to conference hotels. Available on Wednesday & Sunday ONLY.
  Raleigh Marriott City Center Sheraton Raleigh Hotel Residence Inn Raleigh Downtown Other (no shuttle service) I will provide my own transportation. I have not made hotel reservations yet. Please fill out this field.
  
  I would like to pre-order a conference t-shirt. REQUIRED
  Please indicate size & quantity. Payments will only be accepted at time of pick up.
  Please fill out this field.
  
  Shirt Size 1
  
  Size REQUIRED
  Adult sizes only.
  Please fill out this field.
  
  Quantity REQUIRED
  Numbers only.
  Please fill out this field. Please enter valid data.
  
  Shirt Size 2
  
  Size REQUIRED
  Adult sizes only.
  Please fill out this field.
  
  Quantity REQUIRED
  Numbers only.
  Please fill out this field. Please enter valid data.
  
  Shirt Size 3
  
  Size REQUIRED
  Adult sizes only.
  Please fill out this field.
  
  Quantity REQUIRED
  Numbers only.
  Please fill out this field. Please enter valid data.
  
  Shirt Size 4
  
  Size REQUIRED
  Adult sizes only.
  Please fill out this field.
  
  Quantity REQUIRED
  Numbers only.
  Please fill out this field. Please enter valid data.
  
  Shirt Size 5
  
  Size REQUIRED
  Adult sizes only.
  Please fill out this field.
  
  Quantity REQUIRED
  Numbers only.
  Please fill out this field. Please enter valid data.
  
  Shirt Size 6
  
  Size REQUIRED
  Adult sizes only.
  Please fill out this field.
  
  Quantity REQUIRED
  Numbers only.
  Please fill out this field. Please enter valid data.
  
  Shirt Size 7
  
  Size REQUIRED
  Adult sizes only.
  Please fill out this field.
  
  Quantity REQUIRED
  Numbers only.
  Please fill out this field. Please enter valid data.
  
  Pricing & Fees
  
  Conference & Registration Fee REQUIRED 99 – Senior Member 125 – Senior Non-Member 115 – Adult Member 142 – Adult Non-Member 79 – Youth (13-17 yrs.) 62 – Child (4-12 yrs.) 15 – Toddler (3 & Under) Please fill out this field.
  
  Early Bird Discount (Until March 27, 2020)-15.0
  
  Membership Registration/Renewal
  
  NOTE: Valid for next applicable membership year.
  
  Would you like to register or renew your membership? REQUIRED Please fill out this field.
  
  Membership Type REQUIRED
  Valid for next applicable membership year.
  Please fill out this field.
  
  Donation
  Make a contribution to the Friends of Saint Kateri Restricted Fund
  $ Please enter a positive decimal.
  
  Processing Fee10.0
  
  Why a processing fee? It is important for us to be able to offer online registration as a convenient, paperless alternative to our traditional registration forms. For this service, we are charged a nominal fee for every transaction we process online, and have included this flat rate fee as a means of helping us cover this administrative cost.
  
  Total:
  
  Submit
  
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- Enjoy the Member Rates!
  
  If you are a non-member interested in the benefits of membership, you may include membership dues for the current year
  (07/01/2019 - 06/30/2020) in your registration total and become eligible for the member conference fee rate at this time.
- Shuttle Information
  
  If you are registering for the conference but have not yet made your hotel or travel arrangements, please contact our national office as soon as they are confirmed. The annual planning committee is pleased to offer complimentary shuttle service between Raleigh-Durham International Airport and our three conference hotels on Wednesday, July 15, for arrivals and Sunday, July 19, for depatures.
- Concelebration & Assistance for Liturgy
  
  If you are a priest or deacon who wishes to concelebrate or assist in our conference liturgies, please contact Terrie Baldwin at terrie.baldwin@raldioc.org or at (919)821-9710 for a Diocese of Raleigh suitability form and instructions.
  
  Deadline for submission is May 1, 2020.

Two Day Conference Registration

Pricing & Fees