Key Leader Indiana District 2023 | Kiwanis Indiana District

Schedule

Arrival and check-in is from 4 p.m.-6 p.m. Friday, November 3, 2023

The weekend will end 12:00 p.m. Sunday, November 5, 2023.

Attendance is REQUIRED for the entire event – Friday through Sunday.

Event Contact:
Rebecca Mapes – mapesrs@wccsonline.com or call/text (260) 760-0480
Jeff Blasdel – jeffblasdel@gmail.com or call/text (812) 603-6461

Location Information: YMCA Camp Tecumseh

Address: 12635 W Tecumseh Bend Rd, Brookston, IN 47923

Directions: https://www.google.com/maps/di…

Website: https://www.camptecumseh.org/

Note: You can often get help with financial support and transportation from your local Kiwanis club or Key club.

Registration closes on October 15 at Midnight unless the event reaches maximum capacity sooner

Key Leader Registration

Registration Options(Required)

Student Particpant ($150)

Student Facilitator (Application Required) ($100)*[read the information below]

Adult Committee Member ($0)

Adult Non Committee Member (rarely used) ($25)

*Student Facilitator is for Students who have attended Key Leader before or have been asked to apply. You will be sent an application by email once you have registered and will be notified within one week from submission if you are accepted

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Gender(Required)

Male

Female

Date of Birth(Required)

Special Needs (Dietary, Physical, etc.)

Year in School(Required)

High School (attend or affilation)(Required)

Have you attended Key Leader before(Required)

Are you a member of(Required)

T-Shirt Size(Required)

Emergency Contact(Required)

First Last

Relation to Registrant(Required)

Phone(Required)

Total

Payment Option(Required)

Credit Card

Check

Credit Card Payment

Card Details

Cardholder Name

Paying by Check

If you or your sponsor are paying by check, make the check payable to
Indiana Key Leader

And mail to:
Jeff Blasdel
1065 Pine Hill Drive
Columbus, IN. 47201
812.603.6461

If you are receiving financial support from a Kiwanis Club, Key Club, or other sponsors, please pay your share to them and then have your sponsor pay the total amount payable to Indiana Key Leader and include your name or names on the memo line or in an attached note, so we know who is to receive credit for the payment.

FULL PAYMENT MUST BE RECEIVED BY 10/28/2023 TO SAVE YOUR SPOT.