2024 SoDakSACA Leadership Retreat (April 18-20)

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**One registration form must be filled out for each person attending the retreat**
EARLY BIRD REGISTRATION DEADLINE March 30, 2024

Email *

T-shirt size (If your registration is received after March 19th, you may not receive a t-shirt)

small

medium

large

x-large

Clear selection

First Name *

Last Name *

Program or Organization Name *

Street Address *

City *

State *

Zip *

Phone Number *

Choose One Option: *

I am a Current Member of SoDakSACA… $ 160.00

I am not a SoDakSACA Member… $190.00 (Includes 6 month Membership to SoDakSACA)

I do not wish to become a member…. $200.00

National AfterSchool Association (NAA) Membership*
If you’re not a current paid NAA member and live in South Dakota, our state affiliation membership makes you eligible for a free NAA membership (typically $25-150 when purchased directly through NAA). Interested? Please indicate yes or no below. By checking, yes, you’re granting permission for us to share your information with NAA so they can create a membership for you. *

Yes

Please choose an option below for lodge breakfast:
*

I will be staying at the K BAR S Lodge (Breakfast is included with room)

I will not be staying at the Lodge BUT wish to join the group for breakfast each day! (Add $20.00)

I will not be staying at the Lodge and do not need breakfast reserved for me.

Comments: Please let us know about any special dietary needs and/or accommodations you will need.

Payment amount Due:

(Checks must be payable to SoDakSACA)

$160

$190

$200

$20

$10

Registration Fee:

Breakfast Fee $20 (if applicable):

Purchase Order Fee $10 (Charged when an invoice must be sent prior to payment being sent):

Late Registration Fee $20:

Total amount Due: (please add all fees from above) *

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