InterPACK Individual Registration

School Name (if Kiwanis Committee, Circle K Alumni, or Advisor select KIWANIS)*

Registration Type*

Full Weekend (includes lodging, activities, t-shirt and meals) = $45.00 and Saturday Only (includes activities, t-shirt and meals) = $35.00. T-shirts are not guaranteed after registration deadline.

Pronouns

Position*

Cell Phone*

Email*

T-Shirt Color and Size

Please select the color and size for your included Interpack T-shirt.

T-Shirt Color*

T-Shirt Size*

Dietary Restrictions

Do you have any dietary restrictions?*

If yes, please provide details:

Total

Payment*

If paying with a check, please make the check payable to PA Circle K and mail it to: PA District Kiwanis International, P.O. Box 62, Dillsburg, PA 17019. Registration will be cancelled and you will be billed for 50% of the cost, if your check is not received by November 14, 2024 at 5:00 PM.

Credit Card

Card Details

Cardholder Name

CAPTCHA

Kids Need Kiwanis

T-Shirt Color and Size

Dietary Restrictions

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