Follow the Yellow Brick Road

Your Pathway to SuccessMay 3 & 4, 2019

CanadInn – 1792 Pembina HighwayPROMO CODE FOR ROOMS: ($119/nite)

DISTRICT 64 SPRING CONVENTION - REGISTRATION FORM – Pre Conference Pricing Expires April 6

Name_________________________________________________ _________________________________ Toastmaster Designation Club(s): ____________________________________________________________________________________

Current District or International Position________________________________________________________

Phone_________________________

Email___________________________________________________________

Address____________________________________________________________________________________ Street City Prov/ State Postal/Zip Code

Past District Governor? If yes, year___________Past International Offices Held/year(s) ____________

First Timer: _____________

Dietary Restrictions:

Vegan/Vegetarian ________ Nuts ________ Seafood ________

Gluten Free ________ Dairy ________ Other ___________

Pre Conference Special – until April 6th only: $140.00 eTransfer/Cheque/Cash or $145.00 PayPal - Go to http://www.district64.ca/index.php/events/spring-convention and click on the Add to Cart button.

Method of Payment: Cheque _______ Cash _________ eTransfer __________ PayPal ___________ If you are paying by eTransfer, instructions will be emailed to you. Please make all checks payable to District 64 Spring Conference

Send registration form (and payment if applicable) to: Michael & Barb Bayer D64 Spring Convention Co-Chairs. 33 Humber Road Winnipeg, Manitoba R2J 1L7

By registering for this conference, I authorize District 64 to use and publish any of the images taken of me during this event. I understand these images may be used for a variety of Toastmasters related purposes. I am aware that I am not entitled to any compensation and that the images may appear with or without my club’s name. I agree to accept emails from time to time advising me of Conference News and Announcements.

I would like to volunteer to help at the convention