2025 ICON Orlando Tour Registration

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2025 ICON Orlando Tour Registration

This form takes about 10 – 15 minutes to complete. BOTH THE STUDENT AND PARENT/GUARDIAN MUST BE TOGETHER TO COMPLETE THIS FORM.

Parent/Guardian must still be present even if the Key Clubber attending is over the age of 18.

Students will need their Key Club Member ID number to complete this form.

Please plan accordingly as progress cannot be saved.

You will be emailed a copy of this form upon completion.

Email *

Confirm Email Address *

ONLY 50 SEATS ARE AVAILABLE!!!!

To reserve your place on the tour:

Complete this form as soon as possible
Send a deposit of $250 to reserve your seat
DO NOT send a registration form to Key Club International
Pay at least $1,000 of the total tour price by May 9, 2025
THIS NON-REFUNDABLE PAYMENT MUST BE RECEIVED BY MAY 9, 2025
Pay the balance of the total tour price by May 26, 2025

Make all checks payable to:
K–T Key Club District Tour
Mail all checks to:
K–T Key Club
PO Box 39
Rush, KY 41168

For more information, please contact Kira Wilburn at (606) 923-0953 or kira@ktkey.org

Attendee's Legal First Name *

Attendee's Legal Last Name *

Badge Name *

What name do you want to appear on your name badge? Check your spelling!

School Name *

(or Kiwanis club, adult committee, etc. if not affiliated with a school)

Street Address *

City *

State *

Other:

Zip Code *

Gender *

Male

Female

Other:

Attendee's Date of Birth *

YYYY

Key Club Member ID Number *

Attendee's Cell Phone Number *

Home Phone Number

If applicable

Dietary Needs *

Special Accommodations Needed *

Is this your first time attending ICON? *

Yes

Designated Chaperone *

A Chaperone may be a Kiwanian, faculty member, parent, legal guardian, or person in loco parentis, who is over the age of 21, approved by the school, registered with and accompanying the members, & staying at the convention hotel.
A background check is required for all adult non-Key Club members over the age of 18.

No adult(s) other than the parent or legal guardian may share a room with any Key Club member(s).

If you need to have a chaperone appointed, please answer "NEED CHAPERONE"

If you are an adult/chaperone, please answer "ADULT"

Room Preference *

Quad (4 persons per room) for $1499 per person

Triple (3 persons per room) for $1675 per person

Double (2 persons per room) for $1950 per person

Single (1 person per room) for $2750 per person

Roommate Requests (List up to 3 roommates) *

The K–T District will accept room requests for up to 4 per room just so the roommates are requested on the registration form of each individual listed in the room.
The K–T District will assign up to 4 individuals per room only if roommates can be found and all permissions are given.
Each person will be responsible for payment at the rate (single/double/triple/quad) for the actual number of individuals assigned to each room.
Every effort will be made to accommodate rooming requests.
The only way to guarantee roommates is for all students sharing the room to list each other as roommates on each registration form.
The K–T District will let you know the status of your rooming situation by the refund deadline (May 9) in case you need to withdraw from the tour by the cancellation deadline. Furthermore, we will work with you anyway possible to work out the rooming situation you request.
No refunds will be available after May 9, 2025
The K–T District cannot arrange roommates for adults. Adults must send payment for the number of people in their room as it is indicated on this form.

Payment Method *

I am mailing a check (payable to: K–T Key Club District Tour) to the address at the beginning of this form

I CANNOT send a check and need to make arrangements for electronic payment

Deposit Amount *

Please include the amount you are paying as a deposit for the K–T District Tour to the Key Club International Convention.

Payment Agreements *

I understand that $1,000 of the total tour price must be paid by May 9, 2025, and that after May 9, 2025, all money is non-refundable.

I also understand that the total amount must be paid in full by May 26, 2025.

Required

Parent/Guardian First and Last Name *

Parent/Guardian Email Address *

Use an email that is checked often

Parent/Guardian Cell Phone Number *

Tour Registration Commitments and Agreements (Please read the following CAREFULLY)

I understand that I am registering for the Kentucky–Tennessee District Tour (June 29–July 7, 2025) to the Key Club International Convention in Orlando, FL (July 2–6, 2025).
I understand that I do NOT need to complete a separate International Convention registration form.
I understand the payment requirements and deadlines as described above.
I understand that if I cannot attend after sending in my registration and payment, I must notify Kira Wilburn in writing by delivery confirmable US Mail or email by May 9, 2025. (Cancellation must be RECEIVED by May 9, 2025).
*Cancellations received after May 9, 2025 will result in the loss of all money I have paid for the tour.
*The Key Club International deadlines do not apply to me because I am registered as part of the Kentucky–Tennessee District Tour.
*If I find a replacement to fill my spot, the replacement must be of the same gender as I.
*Any replacement for me must be approved by Kira Wilburn.
By registering as a student, I understand that I may be sharing a room with up to three other students (depending on the room type requested and paid for above) and that I may be sharing a bed with another student of the same gender.
The only way to guarantee roommates is for all students sharing the room to list each other as roommates on each registration form.
*Otherwise, I understand that roommates will be assigned to me based on my registration request.
I understand that I will be required to follow the Kentucky–Tennessee District AND the Key Club International Code of Conduct at all times from the start of the tour until the end of the tour.
Failure to follow the code of conduct can result in my removal from the convention and the tour. In the unlikely event this happens, my parent(s) and/or guardian(s) and I understand and agree to the following:
*My parent(s) and or guardian(s) will without delay make travel arrangements for me to leave the tour and convention immediately.
*I agree to travel alone, & I have my parent(s)’ &/or guardian(s)’ permission to travel alone if this occurs.
*These arrangements will be made at the expense of me or my parent(s) or guardian(s).
*No refunds will be made if I am removed from the convention.
Copies of the Code of Conduct and other required forms will be sent to me after I have sent in my tour payment in full and completed this electronic form.

ATTENDEE Electronic Signature *

I, the ATTENDEE, have read and agree to the "Tour Registration Commitments and Agreements" above.

Attendee should type name below.

Electronic signatures in any form whatsoever shall be deemed to have the same force and effect as a manual signature.

PARENT/GUARDIAN Electronic Signature *

I, the PARENT/GUARDIAN, have read and agree to the "Tour Registration Commitments and Agreements" above.

Parent/Guardian should type name below.

Electronic signatures in any form whatsoever shall be deemed to have the same force and effect as a manual signature.

Please type "N/A" if you are an adult/chaperone attendee (does not include Key Club members over the age of 18).

A copy of your responses will be emailed to the address you provided.

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