Capital District International Convention 2022 - Washington DC

The Capital District Tour to ICON 2023 in Anaheim, CA will run from July 4-9, 2023.

The District Tour price includes (for both students & adults):

Convention Registration Fee (this is set by International)
Hotel Accommodations for 5 nights (Tuesday - Saturday)
Continental breakfast each morning
Special District Tour activities including a day at Disneyland
Snacks available daily from the District suite
Daily evening meeting & social time in the District Suite
District t-shirt special for ICON & convention souvenirs
For advisors and chaperones only: Special advisors’ breakfast included

Please complete this form to express your intent to participate in the Anaheim ICON. The total cost of the trip is as follows:

District Tour Prices:

$1450.00 per person (Quad Occupancy with flight)

$1550.00 per person (Triple Occupancy with flight)

$1750.00 per person (Double Occupancy with flight)

$900.00 per person (Quad Occupancy without flight)

$1000.00 per person (Triple Occupancy without flight)

$1250.00 per person (Double Occupancy without flight)

Your spot on the trip is not fully secured until you submit your $400 trip deposit to either via Paypal or by check mailed to:

Capital District Key Club
6129 Strasburg Drive
Centreville, VA 20121

Make all checks payable to: Capital District Key Club

Please be sure that your name appears on the check(s) that are mailed so that your payment is properly credited.

You may also make your payment by credit card through this form. Even though the payment is through Paypal, you are able to pay with any major credit or debit card and you do not need to have a PayPal account to process the payment.

The deadline to pay your trip deposit of $400 is Friday, May 19, 2023.

The second payment of $400 is due no later than Wednesday, May 31, 2023.

The last payment of the remainder of your balance is due by Friday, June 9, 2023.

Flights on the district flight are not guaranteed after May 19^th. No refunds will be given after June 1, 2023.

All questions should be directed to District Administrator Kristina Dlugozima at kmsd512@gmail.com or 703-868-6224

I am a: *

Student

Adult Chaperone

First Name *

Last Name *

Preferred Nickname

Gender: *

Date of Birth *

Email Address *

Phone number *

Do you have any dietary restrictions? *

Parent/Guardian/Emergency Contact Name *

Parent/Guardian/Emergency Contact Phone Number *

Additional Emergency contacts and phone numbers

T-shirt Size *

Name of Key Club

Name of Kiwanis Club (if applicable)

Will you be taking the District flight or flying on own? *

District Flight

Flying on Own

What type of room occupancy do you want?

Double

Triple

Quad

You must pay for the deposit to secure your place on the trip. If you wish to pay by credit card, you may pay for multiple payments at once. Select the amount you wish to pay below.

Deposit ($400.00)

First and second payment ($800.00)

Other amount

Current Total:

$0.00