Kosair Charities Shrine Leaders Conference

Kosair Charities Shrine Leaders Conference

Class Dates: April 4-6, 2022 | Location: Tampa Airport Marriott
PLEASE NOTE: As we will need to communicate directly with the attendee, please list the attendee's personal mailing address, email address and cell/daytime phone number.

THIS FORM MUST BE SUBMITTED PRIOR TO FEBRUARY 25, 2022
Enter Attendee Name *

First Name Last Name
Enter Shrine ID Number *
Temple *
Short Name for Badge (i.e. Bob, John, Mike, etc.) *
Shrine Divan Title *
Select the title you will hold at the time of the conference

Email *
example@example.com
Phone Number *
Please enter a valid phone number.
Address *

Street Address

Street Address Line 2

City State

Zip Code Country
Will your spouse/significant other attend and participate in the training? This information is required for materials and lunches. *

YES NO
Additional Attendee Name *

First Name Last Name
Short Name for Badge (i.e. Chris, Sue, Lou, etc.) *
Additional Attendee Email *
example@example.com
Arrival Date *

Month Day Year
Departure Date *

Month Day Year

ADDITIONAL EVENTS

Kosair Charities Shrine Leaders Social Evening and Dinner
April 5, 2022 - Tickets are $50.00 per person. *

Click Here to Purchase Social Event Dinner Tickets Click Here to Decline Social Event Dinner Tickets
Preferred Payment Method: *

Pay by Credit Card Pay by Check

Event Ticket Selection: *

Leadership Conference

KCSLC2022 - Kosair Charities Shrine Leaders Conference Social Evening & Dinner Ticket An evening of great food and even better fun and fellowship.

$ 50.00 Quantity
Item subtotal: $ 0.00

Total

$ 0.00

Credit Card

Number of Tickets *
Total Amount Due (USD) *
Please make checks payable to Shriners International Educational Foundation, please mail to the address below by March 9, 2022.

Shriners International

ATTN: Chris Harrison

P.O. Box 31356

Tampa, FL 33631-3356

After March 9th, please bring checks to the registration desk.
HOTEL RESERVATIONS

The Tampa Airport Marriott Hotel is offering a group rate of $174.00 USD per night, plus taxes.
DO YOU REQUIRE RESERVATIONS AT THE CONFERENCE HOTEL? *

Yes, I require a sleeping room in the Tampa Airport Marriott. No, I do not require a sleeping room. I have made alternate arrangements.
IMPORTANT: Please follow the booking link on the confirmation page once you've completed this registration form.

PLEASE NOTE: Your reservation will be made directly with the hotel, any changes or cancellations will need to be made through the hotel.
CONFERENCE SUMMARY

Kosair Charities Shrine Leaders Conference

Dress: Business Casual for the Conference - Men with Fezzes

Causual for the Social Event and Arrival/Registration Day Reception

Start Date: Sunday, April 3, 2022 (*Travel and Registration Day)

*There will be limited registration on Monday Morning from 7:00 - 8:00 AM

End Date: Thursday, April 7, 2022 (Travel Day)

Last Day to Register: February 25, 2022

Last Day to Book a Hotel Room: Wednesday, March 9, 2022

Group Rate: $174.00 USD per night, plus applicable taxes.
Should be Empty:

Kosair Charities Shrine Leaders Conference

ADDITIONAL EVENTS

Credit Card