2025 Convention Registration To print a copy of the form to register by mail, CLICK HERE Optimist's Name* First Last I am registering for: Full Conference Registration (includes all meals) One Day Registration Saturday Lunch Saturday Banquet Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail* Your Club Name*Select Club from ListArmuchee #21637Athens, GA #21020Athens, TN #11005Athens-Luncheon, GA #21183Atlanta, GA #21025Atlanta-Meet Up Club, GA #21616Canton, GA #21043Carrollton, GA #21076Cedartown, GA #21080Claxton, TN #11058Cleveland-White County, GA #21306Clinton, TN #11065Columbus, GA #21095Concord-Cedar Bluff-Farragut, TN #11075Dalton-Breakfast, GA #21045Douglas Co., GA #21618East Ridge, TN #11012Emory Decatur #21631Forsyth-Cumming, GA #21078Friendsville-South Blount, TN #11361Gilmer Co. #21006Hall County-Gainesville, GA #21150Hickory Flat, GA #21557Holly Springs #21627Hope 4 Kids #21626Hope 4 Tomorrow-Pike Co., GA #21624International City, GA #21534Jasper, GA #21159Kennesaw, GA #21161Kingston, TN #11183Knoxville, TN #11185Lagrange, GA #21170Laurel Canyon, GA #21609Lithonia-East DeKalb, GA #21528Murfreesboro, TN #11260Newnan, GA #21220North Perimeter, GA #21257Northview-Kodak, TN #11352Reach for the Stars #21636Rome-Noon, GA #21250Sandersville-Tennille, GA #21256Sawnee-Cumming, GA #21546Scenic Chattanooga, TN #11050Senoia, GA #21267Shelbyville, TN #11345Smyrna, GA #21275St Simons Island, GA #21255Summerville-Trion-Noon, GA #21298Temple, GA #21619Trenton-Dade, GA #21311Tucker, GA #21227Tybee Island, GA #21270University Area, TN #11007Warner Robins Noon, GA #21315Waynesboro, GA #21317West Georgia #21630Woodstock-Midday, GA #21319Woodstock-Towne Lake, GA #21335Wrens-North Jefferson, GA #21229Ya Ya Xpress, GA #21614Club not listedAre you the official representative for your club at the Board meeting?* Yes No Is this your first District Conference? Yes No Is this your second District Conference? Yes No Club Office held for 2024-2025Club Office held for 2025-2026District Office held for 2024-2025District Office held for 2025-2026Complete this section only if Spouse/Guest is being registered:Spouse/Guest Name First Last I am registering my Spouse/Guest for Full Conference Registration (includes all meals) One Day Registration Saturday Lunch Saturday Banquet Club Name Spouse/Guest belongs if applicableArmuchee #21637Athens, GA #21020Athens, TN #11005Athens-Luncheon, GA #21183Atlanta, GA #21025Atlanta-Meet Up Club, GA #21616Canton, GA #21043Carrollton, GA #21076Cedartown, GA #21080Claxton, TN #11058Cleveland-White County, GA #21306Clinton, TN #11065Columbus, GA #21095Concord-Cedar Bluff-Farragut, TN #11075Dalton-Breakfast, GA #21045Douglas Co., GA #21618East Ridge, TN #11012Emory Decatur #21631Forsyth-Cumming, GA #21078Friendsville-South Blount, TN #11361Gilmer County, GA #21006Hall County-Gainesville, GA #21150Hickory Flat, GA #21557Holly Springs #21627Hope 4 Kids #21626Hope 4 Tomorrow, GA #21624International City, GA #21534Jasper, GA #21159Kennesaw, GA #21161Kingston, TN #11183Knoxville, TN #11185Lagrange, GA #21170Laurel Canyon, GA #21609Lithonia-East DeKalb, GA #21528Murfreesboro, TN #11260Newnan, GA #21220North Perimeter, GA #21257Northview-Kodak, TN #11352Reach for the Stars #21535Rome-Noon, GA #21250Sandersville-Tennille, GA #21256Sawnee-Cumming, GA #21546Scenic Chattanooga, TN #11050Senoia, GA #21267Shelbyville, TN #11345Smyrna, GA #21275Summerville-Trion-Noon, GA #21298Temple. GA #21619Trenton-Dade, GA #21311Tucker, GA #21227Tybee Island, GA #21270University Area, TN #11007Warner Robins Noon, GA #21315Waynesboro, GA #21317West Georgia #21630Woodstock-Midday, GA #21319Woodstock-Towne Lake, GA #21335Wrens-North Jefferson, GA #21229YaYa Xpress, GA #21614club not on list(not a club member)(not registering a spouse/guest)Is your Spouse/Guest the official representative for the club at the Board meeting? Yes No Is this the first District Conference for your Spouse/Guest? Yes No Is this the second District Conference for your Spouse/Guest? Yes No Spouse/Guest Club Office held for 2024-2025Spouse/Guest Club Office held for 2025-2026Spouse/Guest District Office held for 2024-2025Spouse/Guest District Office held for 2025-2026Complete for all Registrants:I will be* Mailing a check to Jimmy Howard Paying now by credit card or paypal Other Payment comments:Do you have any special requests, food allergies, or comments for the Registrar?*EmailThis field is for validation purposes and should be left unchanged.
