AGM 2025 Registration

Please contact us with any questions you might have before you register.
Email your questions to: AGM2025DVJC@gmail.com

Participant Name

First

Last

Participant Status (check one)

Club Delegate
Sponsor
Staff
General Admission

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Email

Primary Phone

Alternate Phone

JCNA Home Club

JCNA Number

Emergency Contact Name

Emergency Contact Phone

Guest Information

Include Guest

I will be bringing a guest.

Activities and Meal options:

Delegate Registration (no fee for non-delegates)

Price: $95.00

Delegate registration includes: Saturday breakfast and lunch

Delegate Saturday Breakfast and Lunch (no fee for delegates)

I will be attending Saturday's delegate breakfast
I will be attending Saturday's delegate lunch

Saturday delegate's breakfast (no fee for delegates)

1 Delegate Breakfast: $0.00

Saturday delegate's breakfast (no fee for delegates)

Saturday delegate's lunch (no fee for delegates)

1 Delegate Lunch: $0.00

Saturday delegate's lunch (no fee for delegates)

Friday Historic Covered Bridge Driving Tour

Will Attend the Driving Tour
Will Need a Ride
Will Attend Lunch during the Tour

Lunch will be paid on your own at the restaurant.

Friday Welcome Party & Dinner at Simeone Museum

Price per person: $85.00

Saturday Breakfast (for non-delegates)

Price (per person): $40.00

Saturday Lunch (for non-delegates)

Price (per person): $40.00

Guest's Contact Need

Saturday AGM Banquet and Awards Ceremony

Will you be attending the Saturday Banquet and Awards Ceremony?

I will be attending the banquet
I will be bringing a guest to the banquet

Price per person: $100.00

AGM Banquet and Awards Ceremony

One Banquet Ticket: $100.00 (per person)

Meal Restrictions

Do you or your guest have any meal restrictions?

Comments

Feel free to add any additional information that you believe is important for us to know.

Your registration fees:

Item Quantity Qty Total

There are no products selected.

Delegate Registration (no fee for non-delegates) 1 $95.00

Saturday delegate's breakfast (no fee for delegates) 1 $0.00

Saturday delegate's lunch (no fee for delegates) 1 $0.00

Friday Welcome Party & Dinner at Simeone Museum 0 $0.00

Saturday Breakfast (for non-delegates) 0 $0.00

Saturday Lunch (for non-delegates) 0 $0.00

AGM Banquet and Awards Ceremony 1 $100.00

AGM Banquet and Awards Ceremony with Guest 2 $200.00

Total $100.00

Registration and Payment

Card Number

Expiration Date

Security Code

Card Holder Name

PLEASE NOTE: If your total registration fees are $0.00, the registration will fail to process.
Please contact the registrar directly to register. agm2025dvjc@gmail.com

Guest Information

Activities and Meal options:

Saturday AGM Banquet and Awards Ceremony

PLEASE NOTE: If your total registration fees are $0.00, the registration will fail to process. Please contact the registrar directly to register. agm2025dvjc@gmail.com

PLEASE NOTE: If your total registration fees are $0.00, the registration will fail to process.
Please contact the registrar directly to register. agm2025dvjc@gmail.com