Club Name(Required)Select Your Club101 Lakes Angola25+ Kiwanians Who Care – INAkron-MentoneAlexandriaAuburnAvonBatesvilleBedfordBloomingtonBoonvilleBremenBrookvilleBrownsburgCambridge City, New DayCarmelCarmel Golden KCastletonChandlerChesterton-DunelandCiceroClarksvilleClay CountyColumbusColumbus Golden KColumbus, MeridianConnersvilleCrawfordsvilleCulverDaleDanvilleDunkirkEast NobleElberfeldElkhartElwoodEvansvilleEvansville-Green RiverFerdinandFishersFort WayneFort Wayne Time CornersFrankfortFranklinGolden K, RichmondGoshenGoshen, Maple CityGrant County, IndianaGreater Princeton CommunityGreater SheridanGreencastleGreenfieldGreensburg CommunityGreenwoodHighlandHistoric KokomoHistoric New AlbanyHistoric NewburghHobartHollandHuntingburgHuntingtonIndianapolisIndianapolis-Broad RippleIndy GlobalIndy-It's 5 o'clock SomewhereJasperJefferson CountyJohn Chapman, Fort WayneKnute Rockne Memorial, GrangerKokomoKokomo Golden KLa PorteLafayetteLafayette-HarrisonLakeland, North WebsterLawrence SunriseLawrenceburgLebanonLogansportLogansport and Cass CountyMartinsvilleMeridian Hills, IndianapolisMerrillville-BreakfastMetropolitan KokomoMilfordMitchell-GrissomMonticelloMooresvilleMount VernonMuncieMunsterNappaneeNew Castle Henry CountyNew HarmonyNewburghNoblesvilleNoblesville, SunrisersNorth Clark CommunityNorth IndianapolisNorth ManchesterNorth VernonNorthwest IndianapolisOakland CityOoliticOrleansParlor CityPendletonPerry Twp.-IndianapolisPeru-GrissomPetersburgPlainfieldPlymouthPortagePortlandPoseyvillePrincetonRichmondRobin Run Golden K-IndianapolisRochesterRush CountySaint PaulScott CountySeymourShelbyvilleSouth BendSouth Central IndianaSouth SpencerTell CityTerre HauteThorntownTipton (Suns of Tipton)ValparaisoValparaiso SunriseVincennesWabashWarsawWawaseeWestfieldWestportWinamacWinchesterYorktownZionsville/WhitestownOtherName of the ClubIf the club name is not in the list. Please input your club name here.Name(Required) First Last Email(Required) Dietary Restriction(Required) No, I don’t have any restriction Yes, I have a dietary restriction Dietary Restriction DescriptionEarly Bird Registration(Required) Full Weekend Ticket (Includes Education Workshops, House of Delegates, Friday Dinner, All meals on Saturday and Sunday Brunch): $249.00 Friday Night Dinner Only Ticket: $49.00 Saturday Only Ticket (Dinner NOT included): $109.00 Saturday Night Plated Dinner Only Ticket: $59.00 Sunday Brunch Only Ticket: $39.00 Total Credit Card(Required)Card Details Cardholder Name
