73rd NSDC Long Form Registration - 73rd National Square Dance Convention®

Primary Registrant*

Name of the first adult registrant:

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Prior conventions?*

Number of prior National Square Dance Conventions attended?

Please enter a number from 0 to 72.

Email*

Enter Email Confirm Email

Share email address with the NEC?*

Would you like to share your email with the NEC so they can notify you with updates for future conventions? Checking NO will restrict use of your email to communications related to this convention.

Yes

No

Dance leaders?

List the names of any dance leaders included on your registration that wish to be programmed.

Are you pre-Registered?*

Did you pre-register and pay prior to Feb 25th, 2023?

Yes

No

Accommodations*

Tell us about where you plan to stay:

Convention Hotels

Camping / RV

I’ll make my own housing accommodations

Adults:*

This field should match the number of adults you are registering below:

Please enter a number from 1 to 4.

Children:*

Children cannot be registered without an adult registration. This field should match the number of children you are registering below:

Please enter a number from 0 to 8.

Adult Registration *

Price will increase May 1st, 2024 from $65.00 to $80.00.

Price: $65.00

Child Registration

Children cannot be registered without an adult registration. Must be age 5-17 on June 6th, 2024 to qualify for child pricing.Price will increase May 1st, 2024 from $32.50 to $40.00.

Price: $32.50

Badge Information

For each registrant, please enter attendee names and the number of national conventions they have attended as applicable. PLEASE REVIEW YOUR ENTRIES CAREFULLY AS THIS INFORMATION WILL BE PRINTED AS WRITTEN ON THEIR CONVENTION BADGES.

2nd Adult

First Last

2nd Adult Prior Conventions?*

Number of prior National Square Dance Conventions attended?

Please enter a number from 0 to 72.

3rd Adult

First Last

3rd Adult Prior Conventions?*

Number of prior National Square Dance Conventions attended?

Please enter a number from 0 to 72.

4th Adult

First Last

4th Adult Prior Conventions?*

Number of prior National Square Dance Conventions attended?

Please enter a number from 0 to 72.

1st Child*

First Last

1st Child Prior Conventions?*

Number of prior National Square Dance Conventions attended?

Please enter a number from 0 to 72.

1st Child Date of Birth*

In order to qualify for the child registration rate, the child must be 5-17 years old on June 6th, 2024.

2nd Child*

First Last

2nd Child Prior Conventions?*

Number of prior National Square Dance Conventions attended?

Please enter a number from 0 to 72.

2nd Child Date of Birth*

In order to qualify for the child registration rate, the child must be 5-17 years old on June 6th, 2024.

3rd Child*

First Last

3rd Child Prior Conventions*

Number of prior National Square Dance Conventions attended?

Please enter a number from 0 to 72.

3rd Child Date of Birth*

In order to qualify for the child registration rate, the child must be 5-17 years old on June 6th, 2024.

4th Child*

First Last

4th Child Prior Conventions?*

Number of prior National Square Dance Conventions attended?

Please enter a number from 0 to 72.

4th Child Date of Birth*

In order to qualify for the child registration rate, the child must be 5-17 years old on June 6th, 2024.

5th Child*

First Last

5th Child Prior Conventions?*

Number of prior National Square Dance Conventions attended?

Please enter a number from 0 to 72.

5th Child Date of Birth*

In order to qualify for the child registration rate, the child must be 5-17 years old on June 6th, 2024.

6th Child*

First Last

6th Child Prior Conventions?*

Number of prior National Square Dance Conventions attended?

Please enter a number from 0 to 72.

6th Child Date of Birth*

In order to qualify for the child registration rate, the child must be 5-17 years old on June 6th, 2024.

7th Child*

First Last

7th Child Prior Conventions?*

Number of prior National Square Dance Conventions attended?

Please enter a number from 0 to 72.

7th Child Date of Birth*

In order to qualify for the child registration rate, the child must be 5-17 years old on June 6th, 2024.

8th Child*

First Last

8th Child Prior Conventions?*

Number of prior National Square Dance Conventions attended?

Please enter a number from 0 to 72.

8th Child Date of Birth*

In order to qualify for the child registration rate, the child must be 5-17 years old on June 6th, 2024.

Convention Materials

Magnet for Convention Badge

Pin provided free

Price: $2.00

Program Book & Daily Schedules

Price increases to $25 after April 30th, 2024

Price: $20.00

Round Dance Syllabus – USB

Digital copy delivered on a USB thumb drive

Price: $15.00

Round Dance Syllabus – Print

Print copies must be ordered prior to April 30th, 2024

Price: $20.00

Round Dance Syllabus – Print & USB

Print copies must be ordered prior to April 30th, 2024.

Price: $30.00

Cookbook

Price: $15.00

Hearing Assistance Device

Price: $15.00

Wednesday Night Entertainment

The “Wisconsin Singers”

Price: $25.00

Sew & Save Book – USB

Price: $15.00

Sew & Save Book – Digital Download

We will e-mail you a special link to download your Sew & Save book

Price: $15.00

Did you make any purchases?

Selecting no removes the $3 card processing fee.

No, I did not make any purchases

Credit Card Processing Fee*

Price:

Total

Credit Card

Card Details

Cardholder Name

Name

This field is for validation purposes and should be left unchanged.

73rd NSDC Long Form

Badge Information

Convention Materials

Convention Hotel Accommodations

Block Housing

Camping

Wisconsin State Fair Park RV Park

73rd National Square Dance Convention®