CKI DLSSP – SWD Kiwanis

DLSSP is Saturday, March 29th, 8:30 AM in NEED DATE AND TIME Albuquerque, NM. Come join us as we volunteer at
NEED INFORMATION
The registration form is due March 27th. NEED CUTOFF DATE
NEED ANY OTHER INFO YOU WISH TO APPEAR HERE.

First Name *

Last Name *

Phone *

Email *

Are you interested in receiving or providing housing? *

Yes, I would like to receive housing

Yes, I would like to provide housing

I am not interested in either option

If you are interested in providing housing please indicate how many individuals you can house? *

Will you be driving to DLSSP? *

Yes

No

I can drive if needed

If you are driving how many people can you transport? *

Do you have any dietary restrictions? *

Yes

No

Dietary Restrictions (Please check all that apply)

The following is the Code of Conduct as written in the International Policy Code, Section I: Conduct, and will be in effect at all CKI conventions and events.

a. No drugs of any nature, with the exception of prescribed medication, will be permitted in the possession of anyone in attendance.
b. The Circle K International Sponsored Conventions and Events Alcohol Policy, prohibiting the possession, sale, and/or consumption of alcoholic beverages during any event or situation sponsored or promoted by Circle K, will be enforced at all times during the event.
c. Sexual harassment is defined as behavior marked by aggressive or harassing remarks, unwanted physical contact or sexual advances, requests for sexual favors or other verbal or physical conduct of a sexual nature which is unsolicited and offensive to the individual or otherwise creates an intimidating, hostile or offensive environment. Circle K International will not tolerate sexual harassment.
d. Smoking is prohibited. Individuals who wish to smoke must do so outside as permitted by the facility.
e. Care shall be taken not to deface or destroy any property. Any damages will be paid for by the individual responsible.
f. All Circle K members are expected to conduct themselves as responsible, professional men and women and are required to attend all sessions and activities.
g. Every attendee will respect the authority of the District Administrator of Circle K International and the District Board.
h. Infractions of the code of conduct will be reported to the District Board or the District Administrator of Circle K International. Appropriate action will be taken for any infraction, including the dismissal of any attendee from the event at the expense of the individual.
i. The code of conduct is in effect from the moment an attendee arrives at the event until the moment he or she departs.

Agreement *

I agree to abide by the Circle K International Code of Conduct. I will respect the authority of the Circle K International District Administrator and understand infractions of the Code of Conduct will be reported to the District Administrator of Circle K International. I understand that appropriate action will be taken for any infractions, including dismissal from the convention at my expense.

Electronic Signature -- BY ELECTRONICALLY SIGNING BELOW I ACKNOWLEDGE THAT I HAVE READ, UNDERSTAND, AND WILL ABIDE BY THE CODE OF CONDUCT *

As of the date of this registration I am 18 years of age or older *

Yes

No

You are asked to complete a medical waiver.
Please click the link below to download a waiver.
Once you have completed the information email the document to CKI Administrator James Phelps at jphelps1146@gmail.com
or you may hand the document to James at the DLSSP.
To ensure your privacy medical information should only be transmitted directly to James Phelps.

Website/URL

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