Northern Plains District Conference 2023 Registration Form
Please fill out this form for everyone in your household (or those paying together), including any children nursery age or older.

Register for activities for each child using our separate Child/Youth Activities registration form

Everyone over 30 will pay a $10 registration fee.
Meals are $11 for adults, $5 for kids (4-9)

Delegates will receive a conference booklet for free, and the digital version will be available online.  
Printed booklets for non-delegates may be purchased for $8 and picked up at conference or mailed.
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Email *
PARTICIPANTS
Please enter information for each person in your household (including any children nursery age or older), leaving any extra questions blank.  If you have more than 4 people to register, fill out another form after this one.  
Person 1 - Name *
Person 1 - Age Group *
Person 1 - Delegate? *
Person 2 - Name
Person 2 - Age Group
Clear selection
Person 2 - Delegate?
Clear selection
Person 3 - Name
Person 3 - Age Group
Clear selection
Person 3 - Delegate?
Clear selection
Person 4 - Name
Person 4 - Age Group
Clear selection
Person 4 - Delegate?
Clear selection
CONTACT INFORMATION
Please fill out contact information for your household.
Address (including state & zip) *
Phone number *
Congregation *
MEAL & BOOKLET SIGN UP
Meals are $11 for adults (10+) and $5 for children (4-9).  Please indicate how many adult and children's meals are needed, and also how many of those meals should be vegetarian. 

Booklets are $8 for non-delegates and free for delegates.  
Friday Supper - # of Adult meals 10+ ($11)
Friday Supper - # of Child meals 4-9 ($5)
How many of those should be vegetarian meals?
Saturday Lunch - # of Adult meals 10+ ($11)
Saturday Lunch - # of Child meals 4-9 ($5)
How many of those should be vegetarian meals?
Saturday Supper - # of Adult meals 10+ ($11)
Saturday Supper - # of Child meals 4-9 ($5)
How many of those should be vegetarian meals?
Number of physical booklets needed for non-delegates ($8)
If you would like your booklet mailed, enter your mailing address.  Otherwise you may pick it up at conference.
CALCULATING PAYMENT:
Here you will add up your registration, meal, booklet fees, and optional donation to calculate your total payment.  You may use the following questions to help calculate your total, or skip to Payment Total if you can calculate easily in your head.
Registration subtotal - total # of adult (31+) registrants x $10:
Adult meal subtotal - total # of adult meals x $11:
Child meal subtotal - total # of child meals x $5:
Booklet subtotal - # of non-delegate booklets x $8:
Optional District Donation Amount:
Payment Total - add up all subtotals + optional donation amount: *
Online Payment Total - if you plan to pay online, add 3% by calculating Payment Total x 1.03:
PAYMENT:
There are two options for payment:
  
1. Pay using our online checkout (incurs a 3% service fee).  Don't forget to come back and submit this form afterwards! 

2. Make out a check to "Northern Plains District" and mail to:
Ida Van Westen
District Conference Support
21284 Knauf Ave
Reading MN 56165
My Payment Choice: *
A copy of your responses will be emailed to the address you provided.
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