Registration We are glad to see you're interested in joining with NLOMA for the 2021 Conference! In order to register for this event, please complete and submit the following registration form.Registrant Basic InformationRegistration IDName* First Last Gender*MaleFemaleEmail* Enter Email Confirm Email Cell Phone*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Organization Name*If not currently associated with a Camp, please put none. Position Emergency ContactName* First Last Relationship* Phone*Registration & HousingPlease select double occupancy if your spouse and/or child is attending with you. I'll be attending…* Conference & Joint Recruitment Conference Only Joint Recruitment Only Housing - Conference & JR*Sunday, Feb 14 to Friday, Feb 19Single Occupancy - $510Double Occupancy - $375Triple/Quad Occupancy - $320Housing - Conference Only*Sunday, Feb 14 to Thursday, Feb 18Single Occupancy - $445Double Occupancy - $335Triple Occupancy - $285Housing - JR Only*Wednesday, Feb 17 to Friday, Feb 19Single Occupancy - $315Double Occupancy - $250Triple/Quad Occupancy - $220Roommate Request 1 First Last Roommate Request 2 First Last Roommate Request 3 First Last Spouse RegistrationNoneConference & JR - $325Conference Only - $265Jr Only - $200Spouse NameIf Spouse is attending. First Last Child RegistrationConference & JR - $160Conference Only - $125NoneChild NameIf child is attending. First Last Are You a NLOMA Member?*Non-Members pay $100 more for Conference Fee. Go to nloma.org/membership/ to enroll as a member today. I'm a NLOMA Member Not a NLOMA Member Are you registering as an Emerging Leader? Yes No Have you been approved for the Emerging Leaders grant?For registrants who have applied for and been awarded an Emerging Leader grant. Yes No Arrival & DepartureArrival Method* I am driving. I am flying. Arrival InfoTo and from Indianapolis. NLOMA Shuttle Indianapolis - $15 No Shuttle Needed Flight Number (Arrival) Arrival Time Flight Number (Departure) Departure Time Personal Needs & PreferencesDietary Restrictions None Vegetarian Vegan Gluten-free Lactose Intolerant Do you have any mobility issues we could help accommodate?Conference SessionWhite Board ConversationsWhat camp ministry topics would you like to see discussed in White Board Conversations? Examples could be ministry itself to database/registration software to COVID Safety. PaymentAre You a NLOMA Member? Non-Members pay $100 more for Conference Fee. Go to nloma.org/membership/ to enroll as a member today. Total Payment*You can either make an online payment or mail in a check. Process online payment Print and send check via postal mail Credit Card*Card Details Cardholder Name Submitting this form will provide you with a printable PDF conference registration that you can then mail along with payment.PhoneThis field is for validation purposes and should be left unchanged.