MyEventRunner - Event Public Fill

Imagine Rotary
Rotary District 6840 District Conference 2023
University of Southern Mississippi
Hattiesburg, Mississippi
April 20-23, 2023

Optional: Do you have a ClubRunner login?

User Name:

Password:

Your Information

First Name:

Last Name:

Badge Name:

Email:

Club Name:

Preferred Phone:

Secondary Phone:

Address 1:

Address 2:

City:

Zip/Postal Code:

Country:

State/Province:

I consent to the collection, storage, and use of my information by District 6840 as described in this Privacy Policy. I understand that I may receive emails regarding this event and other relevant information, and can opt out at any time.

Group:

Rotarians
Non-Rotarians/Spouses/Partners
ADMIN USE ONLY

Your Partner/Guest Information

First Name:

Last Name:

Badge Name:

Email:

Club Name:

Preferred Phone:

Secondary Phone:

Address 1:

Address 2:

City:

Zip/Postal Code:

Country:

State/Province:

I consent to the collection, storage, and use of my information by District 6840 as described in this Privacy Policy. I understand that I may receive emails regarding this event and other relevant information, and can opt out at any time.

Group:

Rotarians
Non-Rotarians/Spouses/Partners
ADMIN USE ONLY

Select Options