2012 KT District Convention
94th Annual District Convention
August 9-12, 2012
Park Vista Hotel, Gatlinburg, TN
Official Registration Form
Name____________________________________________________________Division (1-18) _______
Club Name______________________________________________________ KY TN
Daytime Phone___________________________Email_________________________________________
Spouse or Guest_______________________________________________________________________
Early On-Site
Early Bird Full Registration (Before August 1st) 120.00 130.00
This includes 3 meals listed below and registration
Registration Only 85.00 95.00
No meals included
Foundation Luncheon (Sat. Aug. 11) “The Smokehouse Buffet” 28.00
All Kiwanians must pay registration fee to attend this function.
Guest or Spouse may attend without paying registration.
Governor’s Banquet (Sat. Aug. 11th) 40.00
All Kiwanians must pay registration fee to attend this function.
Guest or Spouse may attend without paying registration.
Memorial Breakfast (Sun. Aug. 12th) 20.00
All Kiwanians must pay registration fee to attend this function.
Guest or Spouse may attend without paying registration.
Total ____________
Special Food Requirements:
No Sugar No Red Meat No Dairy Other _________________________________
I plan to attend CLE Friday August 9, 2012 from 1:00-4:00 (No Fee) YES NO
Are you a first time Attendee? Yes No
To make room reservations please call: The Park Vista
705 Cherokee Orchard Road
Gatlinburg, TN 37738
1-800-421-7275 Must use code: KTK
Room Rate is 109.00 per night (plus tax)
After July 9, 2012 the above rate of $109.00 is not guaranteed.
Please send registration form and payment to: KY-TN District of Kiwanis
1035 Strader Drive Suite 150-1
Lexington, KY 40505
Fax-859-422-2259
Please make check payable to KT District of Kiwanis International
Questions? Please call 859-422-2256 or email ktdistrict@kytnkiwanis.org
