A. Registration InformationTitleName(Required) First Last Preferred PronounsBadge Name(Required)First Name or Preferred NicknameCongregation/Organization NameIf applicableAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email(Required) Enter Email Confirm Email Day Phone(Required)Cell Phone(Required)Photo/Video Release(Required)By checking the box below, I/we hereby grant the Cantors Assembly permission to audio and/or video record any presentation I/we might make during this year's Annual Convention, sung or spoken. In addition, the Cantors Assembly has the right to live stream and/or sell recordings of such presentations. The Cantors Assembly may use my/our name(s), likeness (e.g. photograph) and/or biographical material about me/us for any legitimate purpose in any media and in such manner at such times as the Cantors Assembly, in its sole discretion, may deem appropriate or desirable without compensation to me/us, provided that such usage relates to my/our status as a participant in the Convention. I/we hereby waive all right of inspection prior to release. I agree.B. Registration/Meal FeesPlease note the cost of registration includes dinner and a dessert reception as well as our evening concerts.Which days do you plan to attend?(Required) Sunday Monday Tuesday Wednesday Registration for Day Pass Quantity(Required)$115 per Day Pass per person/per day Price: $115.00 Quantity Registration Subtotal $0.00 C. Meal PreferencesMy Meal Request No red meat, but poultry and fish are okay. No poultry or red meat, but fish is okay. Vegetarian (Dairy is okay) Vegan (no animal products whatsoever) Additional Dietary Needs Gluten-Free Low Sodium Other Meal choices must be considered final and cannot be changed at the convention. E. SwagWould you like to take home some amazing Cantors Assembly Merchandise? We will have so many items for sale at convention, but for a discounted price, you can order them now and pick them up at the Registration Desk!Shaker Egg Quantity Price: $5.00 Quantity Kippah/Yarmulke Quantity Price: $36.00 Quantity Baseball Hat Quantity Price: $18.00 Quantity Water Bottle Quantity Price: $10.00 Quantity Backpacks $25No, Thank you!Grey/BlackBlue/BlackTote Bags - $18No, Thank you!Grey/BlackBlue/BlackF. PaymentWould you like to make an additional donation?If so, please write in the amount in the field below Total Credit Card(Required) Do you have any additional questions or comments?
