Fillable JOOI CONVENTION REGISTRATION FORM

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JOOI CONVENTION REGISTRATION FORM

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JOOI CONVENTION REGISTRATION FORM
Baltimore Renaissance Harborplace Hotel • Baltimore, Maryland • July 5-7, 2011
Advanced registration deadline is June 15. Register online at www.jooi.org by selecting the JOOI Convention.
Instructions: Please print. Fill in all blanks accordingly. One form per person. Incomplete forms will be returned.
District Name/Number:______________________________________Sponsor Club Number:______________________
JOOI Club Name:____________________________________________JOOI Club Number:_________________________
Registrant’s Name:______________________________________________________________________________________
(First) (Middle Initial) (Last) (D/O/B) (Nickname printed on badge)
Address:_______________________________________________________________________________________________
(Street) (City) (State/Province) (Postal/ZIP Code) (Country)
Phone Number: _____________________________________E-Mail:_____________________________________________
Name of Chaperone:____________________________________________________________________________________
Emergency Contact Person:______________________________________________________________________________
(Name) (Relationship) (Daytime Phone)
_______________________________________________________________________________________________________
(Evening Phone) (E-mail)
Special Needs: _________________________________________________________________________________________
Please mark all boxes that apply:
o I am a JOOI Club member: o I am a Chaperone/Adviser o I am a JOOI District officer
o I am a JOOI Club officer: o I am an Optimist Club Member: o Governor o Governor-Elect
o President o I am a Youth Club Chairperson o Lt. Governor o Lt. Gov.-Elect
o President-Elect o I am a District YC Chairperson o Sec./Treas. o Sec./Treas.-Elect
o Secretary/Treasurer o Other (Please specify)___________
o Secretary/Treasurer-Elect
o Other (Please specify)___________
*Registration Fees:
Note: Includes the cost of function space, workshops, speakers, supplies, entertainment & meals starting with dinner on July
5 and ending with the JOOI President’s Banquet on July 7. Please note that breakfast is not included. All housing fees
are noted on a separate form that must be submitted directly to the Baltimore Renaissance Harborplace Hotel.
Youth: o Advance Registration (Postmarked by June 15, 2011) – $250 US/CAN
Adult: o Advance Registration (Postmarked by June 15, 2011) – $250 US/CAN
o Single-Day Registration (Postmarked by June 15, 2011) Tuesday, July 5 – $65 US/CAN
o Single-Day Registration (Postmarked by June 15, 2011) Wednesday, July 6 – $95 US/CAN
o Single-Day Registration (Postmarked by June 15, 2011) Thursday, July 7 – $95 US/CAN
*On-Site Registration Fees:
o Full Registration (Adult or Youth) – $275 US/CAN
o Single-Day Registration – Tuesday, July 5 – $75 US/CAN
o Single-Day Registration – Wednesday, July 6– $105 US/CAN
o Single-Day Registration – Thursday, July 7 – $105 US/CAN
*Canadian amount is based on exchange rate at time of payment.
*Convention T-Shirt: $15 (US)/(CAN)
All shirts are in adult sizes only.
o Small o Medium o Large o X-Large o XX-Large (Add $1.50) o XXX-Large (Add $3)
Method of Payment:
o Check (Payable to Optimist International) o Credit Card Total Amount Due______________
Credit Card Type: o MasterCard o Visa o American Express o Discover
Credit Card Number:________________________________________________________ Expiration Date:_____________
Cardholder’s Name:____________________________________________ Phone Number: __________________________
Cardholder’s Address: __________________________________________________________________________________
Cancellation Policy: All requests must be received IN WRITING by June 17, 2011. Refund requests
will not be accepted after this date.
Mail/Fax this form to: JOOI Clubs Department, Optimist International, 4494 Lindell Blvd.,
St. Louis, MO 63108; Phone: 800-500-8130 or 314-371-6000, ext. 218;
Fax: 314-735-4118 (credit card requests only)
Registrations can also be made with a credit card at www.jooi.org.
* JOOI Convention meals provided:
July 5 – Dinner – Beach Theme
July 6– Lunch, Dinner – Gilligan’s Island Theme
July 7 – Lunch, President’s Dinner – Going Fishing Theme
* You are encouraged to dress according to the theme days listed above. You may wear your themed clothes throughout
the day every day but on the last night for the President’s Banquet and Closing Session. During those events you must
wear your best dress attire.
http://www.harborplace.com
FORT McHENRY
National Monument & Historic Shrine
LANDING 17 • IN SEASON ONLY
Last Boat Leaves the Fort at 5:00PM
Birthplace of the Star Spangled Banner
Prison for Southern Sympathizers during the Civil War
Baltimore Defense during the War of 1812
Steamed Crab Locations
Water Taxi Transfer Points
Star-Spangled Trails
Seafarerís Walk
(Harbor East/Fellís Point)
Visitor Center
Federal Hill / Locust Point
Downtown
Harborplace Waterside Pavilions
Little Italy / Harbor East
Fellís Point
Canton
K E Y
passed.
This Landing open
April 1st thru Sept. 30th
T
T
S
See
Fell’s Point
Map on
other side
T
Transfer
for Inside
& Express
Routes
Transfer for
Express and
Far East/Fort
McHenry Routes
S
Baltimore Marriott
Waterfront Hotel
Renaissance
Harborplace Hotel
Baltimore, MD • Inner Harbor
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Completed 12 December 2019

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