2020 MD-6 State Lions Convention Official Registration Form

Select:

Name:

First NameLast Name

First Lions Convention?

YesNo

Club Name:

District:

Mailing Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Telephone Number:

(Include Area Code)

Email:

example@example.com

Select:

Name:

First NameLast Name

First Lions Convention?

YesNo

Club Name:

District:

Mailing Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Telephone Number:

(Include Area Code)

Email

example@example.com

(Lions/Leos must be registered for the convention to be able to vote or attend any function of the convention!)

EARLY REGISTRATION DEADLINE IS APRIL 15, 2020

Late registration fee (after April 15th): $45.00 per person

No meals may be available for registrations received after April 30!!!

Select each event you will be attending below and enter the amount of attendees.

If you are attending all events, please scroll down to the bottom of the list and select the Full Convention option. Note: If registration is after April 15th, please select the Full Convention (booked after April 15th) option.

Early Registration Fee (booked by April 15th)$10.00

Leo - $10.00	Number of Attendees	Price
Leo		$10.00
Not a Leo		$20.00

Late Registration Fee (booked after April 15th)$15.00

Leo - $10.00	Number of Attendees	Price
Leo		$15.00
Not a Leo		$45.00

Friday Dinner$20.00

Number of Attendees

Saturday Breakfast with the Eye Bank$ Free

Thank the Eye Bank!

Number of Attendees

Saturday Luncheon$20.00

Number of Attendees

Saturday Dinner$20.00

Number of Attendees

OR Full Convention (booked by April 15th), early registration fee and all meals included$80.00

Number of Attendees

OR Full Convention (booked after April 15th), late registration fee and all meals included$100.00

Number of Attendees

Total $0.00

Please advise any dietary restrictions or special needs below:

Will you be participating in the Community Service Project at Weld Food Bank?

YesNo

If yes, how many will be participating?

If paying by check:

Please make check payable to: Lions State Convention Fund

Mail this form (completed) and check to:

Lion Cara Draegert

MD-6 State Convention

105 E. Edison

Brush, CO 80723

Phone: (970) 370-0364

Email: hummingbirdpress@yahoo.com

For more information, please contact CC Carol Lambert at (970) 370-0364 or carollmbrt@yahoo.com

Room reservations can also be made with the DoubleTree online at: https://secure3.hilton.com/en_US/dt/reservation/book.htm?inputModule=HOTEL&ctyhocn=DENGCDT&spec_plan=CDTC-CLS&arrival=20200513&departure=20200517&cid=OM,WW,HILTONLINK,EN,DirectLink&fromId=HILTONLINKDIRECT

(copy as needed for your club members)

If paying by check, do not click "Submit." Print out the completed form and mail the form, along with your check, to the address listed above.

Clicking "Submit" will allow you to pay online.