Kosair Charities Shrine Leaders Conference

Kosair Charities Shrine Leaders Conference

Class Dates: March 10 - 12, 2025 | Location: Tampa Airport Marriott
THIS FORM MUST BE SUBMITTED PRIOR TO FEBRUARY 17, 2025

THE DATES NOTED ABOVE ARE THE CLASS DATES. ARRIVAL AND REGISTRATION WILL BE ON SUNDAY, MARCH 9th. IF YOU ARRIVE AFTER REGISTRATION CLOSES, ON THE, WE WILL HAVE REGISTRATION, PRIOR TO THE OPENING SESSION, ON MONDAY MORNING STARTING AT 7:00 AM. YOUR DEPARTURE CAN BE PLANNED FOR EARLY EVENING ON WEDNESDAY, MARCH 12th OR ANY TIME ON THURSDAY, MARCH 13th.

PLEASE NOTE: As we will need to communicate directly with the attendee, please list the attendee's personal mailing address, email address and cell/daytime phone number rather than the Temple's contact information.

If you wish the Temple Business Office to receive a copy of your registration, please enter the email address below.
Temple's Email Address
Optional
Attendee Name*

First NameLast Name
Shrine ID Number*
Temple Name*
Name Only - Do Not include "Shrine" or "Shriners"
Badge - Short Name (i.e. Bob, Mike, etc.)*
Shrine Divan Title*
Select the title you will hold at the time of the conference
PLEASE DOUBLE CHECK THE SPELLING OF YOUR NAME

AND TEMPLE, AND USE PROPER CASE, AS IT WILL BE PRINTED

ON YOUR BADGE AS ENTERED ABOVE

(ex. Steven vs STEVEN)
Attendee's Email*
example@example.com
Attendee's Phone Number
Please enter a valid phone number.
Attendee's Phone Number (please note drop down box to select country)*
Attendee's Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Will your spouse/significant other attend and participate in the training? This information is required for materials and lunches.*

YESNO
Additional Attendee Name*

First NameLast Name
Badge - Short Name (i.e. Sue, Jess, etc.)*
Additional Attendee Email*
example@example.com
PLEASE NOTE: Entering your arrival and departure dates in the section below will not secure sleeping room accomodations, this is informational only.
Arrival Date*

MonthDayYear
Departure Date*

MonthDayYear
ADDITIONAL EVENTS

Kosair Charities Shrine Leaders Social Evening and Dinner
To celebrate our international reach, within both our Fraternity and our Hospital system, we are having an "Around the World" themed social event.

Please join us in celebrating by honoring your familial roots by dressing specific to your ancestry or enlighten your fellow Shriners by wearing items meaningful to your culture.

Let's have a fun and respectful time sharing where we come from and celebrating our status as an international entity!
March 11, 2025 - Tickets are $60.00 per person*

Click Here to Purchase Social Event Dinner TicketsClick Here to Decline Social Event Dinner Tickets
Preferred Payment Method:*

Pay by Credit CardPay by Check

Complete the below section to Pay by Credit Card*

KCSLC2025 - Kosair Charities Shrine Leaders Conference Social Evening and Dinner TicketSelect number of tickets needed to proceed to credit card payment.

$60.00 Quantity
Item subtotal:$0.00

Total

$0.00

Credit Card

Number of Tickets*
Please make checks payable to Shriners International Educational Foundation, please mail to the address below by February 21, 2025.

Shriners International

ATTN: Summer Blackburn

P.O. Box 31356

Tampa, FL 33631-3356

After February 21st, please bring checks to the registration desk.
HOTEL RESERVATIONS

ATTENTION: The Tampa Airport Marriott Hotel block is $209 per night, plus applicable taxes. The last day to reserve your hotel room through the block is February 16, 2025. HOWEVER, due to high demand, it is likely the block will sell out before this date. Do not wait until the last minute to secure your reservation.

After submitting this form, a Thank You page with a link to the Marriott website, will appear. Use the link on the Thank You page to secure your reservation, with the block rate, directly through the Tampa Airport Marriott website.

IMPORTANT: This room block is for Attendees Only. Do NOT make other reservations for unregistered attendees. If you are making a reservation for another Attendee who has already submitted this registration form, make sure to include their name on the hotel reservation.

**Shriners International does not make hotel reservations on your behalf**
I have read the above and understand how to secure a room reservation at the Tampa Airport Marriott*

Agree
CONFERENCE SUMMARY

Start Date: Sunday, March 9, 2025 (Travel and Registration Day* - Plan to arrive this day)

*There will be limited registration on Monday, March 10 from 7:00 - 8:00 AM

Dates of Classes: March 10 - 12, 2025

*Social Event on March 11 from 6 - 10pm

End Date: Thursday, March 13, 2025 (Travel Day)

Last Day to Register: Monday, February 17, 2025

Dress: Business Casual for the Conference - Men with Fezzes

Casual for the Social Event and Arrival/Registration Day

*Social event and dinner is casual - Fez not needed
REMINDER

Shriners International does not secure a hotel reservation on your behalf. After pressing Submit, please view the Thank You page. There will be a link to the Marriott website where you will secure your reservation.
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Kosair Charities Shrine Leaders Conference

THIS FORM MUST BE SUBMITTED PRIOR TO FEBRUARY 17, 2025

ADDITIONAL EVENTS

Credit Card

REMINDER