Registration

Name:

Address

City

State

Zip Code

Mobile Phone:

Email:

Emergency Contact

Phone/VP

D/H/D-LV

Need Voice Interpreter?

YES

NO

ICDA-US Member?

YES

NO

Lifetime Member?

YES

NO

Chapter Member?

YES

NO

Chapter #

Conference Fee

Member Combo - $150

Non-Member Combo - $175

Member - Friday Only Day Hop - $40

Non-Member - Friday Only Day Hop - $55

Member - Saturday Only Day Hop - $110

Non-Member - Saturday Only Day Hop - $125

Member - Saturday Banquet Only - $60

Non-Member - Saturday Banquet Only - $85

Sunday Only Day Hop - Open to ALL - FREE

Special Dietary Needs:

Free Text

Online Payment will be available after July 8, 2025.

REGISTRATION