Congress 2026 Registration

Congress 2026 Registration
Age Group*

Active DeMolay/SquireSenior DeMolay/Adult/Advisor

Are you registering more the one person?*

YesNo
If you have click yes, you will have an option to select combine payments. This is a manual process and you will receive an email for additional questions. Upon reply to email, you will receive an invoice which will be able to be paid via electronic methods. Checks & cash will not be accepted.

Registrant Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
Chapter*

Medical Information
Data Privacy & Confidentiality Notice We collect health-related data to provide a safe environment and appropriate medical response if necessary.

Purpose: Information regarding physical conditions or medications is used only for emergency preparedness.
Disclosure: We will not sell or share your medical data with third parties, except for emergency medical personnel should an incident occur.
Your Rights: You may request to review or update your submitted information at any time prior to the event by contacting registrations@mddemolay.org.
Retention: All digital and physical copies of sensitive health data will be permanently destroyed 30 days after the event.
Name of Insurance Company*
Policy Number*
Do you take any medications?*

YesNo
Do you have any medical issues or allergies?*

YesNo
Medications - Please list (one medicine per line.)*
Medical Issues or Allergies - Please describe.*
Emergency Contact*

First NameLast Name
Emergency Contact Relationship*
Emergency Contact Phone*
Please enter a valid phone number.

Permission Sheet

{name}, a member of {chapter} Chapter Order of DeMolay, has my/our permission to travel to Congress being held at Boumi Shrine, 5050 King Ave, Rosedale, MD 21237 & Hilton Garden Inn Baltimore/White Marsh, 5015 Campbell Blvd, Baltimore, 21236 on the Friday, March 13th, 2026 (5:00pm) to Sunday, March 15th, 2026 (11:00am). I/We understand that he (she) will be traveling by private vehicle. I/We also understand that the accompanying advisor/chaperone will make every effort to supervise and protect my/our son, however, they shall not be responsible for accidents while in the advisor’s/chaperone’s charge. The advisor/chaperone has the authority to have my/our son treated at an accredited medical facility in case of an emergency. I/We authorize treatment and request that the medical charges be placed against my/our medical insurance, since DeMolay only carries liability insurance.

Name of Insurance Company (required)
{nameOf}

Policy Number (required)
{policyNumber}

My son has the following allergies or medical conditions:
{typeA23}
My son takes the following medication:
{typeA}
Signed (required):___________________________________________
Parent or Guardian
Emergency Number (required):{emergencyContact39}
Name: {emergencyContact} Relationship: {emergencyContact40}
Signature

Clear

My Products*

Active DeMolay/SquireIncludes Hotel and Event

$75.00

Senior DeMolay/Adult/AdvisorIncludes Hotel (Double Occupancy) and Event

$75.00

Total

$0.00

Credit Card

Combined Payments - Please note that you will need to hit submit below.

This is a manual process and you will receive an email for additional questions. Upon reply to email, you will receive an invoice which will be able to be paid via electronic methods. Checks & cash will not be accepted.
Should be Empty: