DignityUSA23rdndNationalConference
RegistrationForm
July6ththroughJuly9th,2017
BostonParkPlazaHotel,50ParkPlaza,Boston,
Massachusetts
Pleasereadthroughthecompleteregistrationinformation,thenon
thelasttwopages,indicateyourchoicesandprices.Youneedonlyto
mailbackthefinaltwopagestotheDignityUSAoffice.
FullConference
AttendanceatthefullDignityUSAConferenceincludes:TheOpeningCeremoniesandSocial,allplenary
sessionsandworkshops,allprayerexperiencesandliturgies,yourchoiceofcaucusactivities,thePresident’s
Lunch,SaturdayDance,andtheSundayCommissioningBrunch.Allratesareperperson.
Pre-Registered–Toqualifyforpre-registrationrate,
youmusthavealreadypaidthe$100downpayment
(perperson).
DignityUSAPre-Registration
Rate:$265(aftera10%discountof$30)lessthe
$100deposit=$165balancedue
EarlyRegistration-Registrationsmustbereceivedno
laterthan4/1/17
DignityUSAMemberRate:
$295
RegularRegistration-Registrationsmustbereceived
nolaterthan5/31/17
DignityUSAMemberRate:
$310
Non-MemberRate:$370
Non-MemberRate:$385
LateRegistration-Registrationsreceivedafter5/31/17 DignityUSAMemberRate:
$340
Non-MemberRate:$415
YoungAdultRegistration-30yearsoldorunder
YoungAdultRate:$175
SpecialFirstTimeAttendees
SpecialRate:$265
SingleDayEvents(OmitifregisteringforfullConference)
OneDayOnly–Friday(includeskeynotebyRev.
PamelaLightsey,oneworkshopsessionand
membershipmeeting)
$125
OneDayOnly–Saturday(includesplenarypanelwith
JamieManson,Rev.LouisMitchell,WalterRobinson,
twoworkshopsessions,President’sLuncheon,and
Dance)
$140
SaturdayDanceOnly
$35
SundayBrunchandCommissioningOnly
$65
BostonHarborSunsetCruise
JointheotherConferenceattendeesandtheirguestsonFridayevening,July7rd,from7:30to9:30PMfora
cruiseonscenic,historicBostonHarbor.Bustransportationwillbeprovidedtoandfromthehotel.Therewill
beacashbarservingbeveragesandsnacks.AndyougetbackintimetoenjoyBoston’snight-life!Thereare
only150ticketsavailableandtheywillbesoldonafirstcomefirstservedbasis.Thisisafundraiserfor
DignityUSA-thecostisonly$65perperson-soitissuretoselloutfast.
SponsorshipOpportunities
Whileanamountissuggestedforeachevent,yourdonationcanbeatanylevel.Theseamountsare
considereddonationstoDignityUSAandaretaxdeductibletotheextentpermittedbylaw.Multipledonors
canshareanysponsorship.Partialsponsorshipsofanyeventarewelcomed.Scholarshipsareespecially
importanttohelpouryoungadultmembersattended.Youwillreceivenamerecognitionunlessindicated
otherwiseonthereturnform.
PlenarySessions:
$2000fullsponsorshipofKeynote
$1500forPlenaryPanel
$500forsinglePlenaryPanelspeaker
WorkshopSession:
$300eachsessionwithdomesticspeaker(s)
$1,000forinternationalspeaker(s)
OpeningCeremonies-$500
Pre-ConferenceLeadershipTraining-$500
Chapel-$200
MusicforChoir-$300
Liturgy-$200
FlowersforConference-$50
SaturdayEveningDance-$500
SundayCommissioningBrunch-$500
Scholarships–Anyamountiswelcome
OtherContributions–Anyamountiswelcome.
DisplayAdsforProgramBooklet
TheseamountsareconsidereddonationstoDignityUSAandaretaxdeductibletotheextentpermittedbylaw.
PrintreadygraphicsmustbesentbyemailtoDignityUSAbyMay1,2017.
FullPage(8”X10”)-$500
HalfPage(8”x5”or5”x8”)-$250
QuarterPage(4”x5”or5”x4”)-$150
EighthPage(2.5”x4”or4”by2.5”)-$100
Greeting-$25(Nameandtext–maximumof50characters,includingspaces)
ConferenceLogoItems
Itemscanbepre-orderedforpickupduringregistration.DeadlinetoorderisJune10,2017.
Ceramicmug-$10
ShortsleeveT-shirt-$15
Poloshirt-$30
LongsleeveT-shirt-$20
HoodedFullZipSweatshirt-$45
Registrationisalsoavailablefor:
LeadershipSeminar,Thursday,July6nd,9:00am–12:00pm.Freetoall,butregistrationrequired.
GroupDinners,SaturdayJuly8,2017
BetweenourEucharisticLiturgyandourDanceonSaturdaynight,youarewelcometoexploreBoston’sdiversedining
sceneonyourown,ortojoinagroupforno-hostdinner.Asofthiswriting,thefollowinggroupswillbeorganizinggroup
dinners;checkatregistrationtoseeifthereareadditionalgroupsyoumaybeinterestedinjoining.
DefendersLeather/LeviCaucus
TransgenderSupportCaucus
WomenofDignity
YoungAdults
HotelRegistration
TheHeadquartershotelfortheDignityUSA2017ConferencewillbetheBostonParkPlaza,50ParkPlazaatArlington
Street,indowntownBoston.
DignityUSAhasnegotiatedaspecialroomratefortheConferenceduringthebusytouristseason.Theroomrateis
$169pernight,singleordoubleoccupancy(plustaxes)withanadditionalfeeof$20forupto4adultsinaroom.The
conferencerateisgoodfromJuly2toWednesday,July11,2017.Thecut-offdateforreservingattheConferencerate
isMonday,June15,2017.Ratesdonotincludetaxes,whichcurrentlyare14.5%.BasicWi-Fiwillbecomplimentaryin
alltheguestroomsreservedusingtheDignityUSAblock,withenhancedWi-Fiavailableforanadditionalfee.
Reservationsmaybemadebyphoneortheinternet.Thephonenumbersforcallinreservationsare1-617-379-7129
or1-617-426-2000.UsetheConferenceName"DignityUSA2017Conference”whencallingtoensureyoureceivethe
specialrates.
Toreserveonline,usetheURL
https://bostonparkplaza.reztrip.com/classic/en/special_offer?action=show&controller=landings&locale=en&rate_code
=DIGUSA&rate_code=DIGUSA&starting_page=special_offer&vr=3
TransportationtotheHotel
FromBostonLoganAirport:TaketheTtoeithertheArlington(GreenLine–1blockfromhotel)orBackBay(Orange
Line–3blocksfromhotel).ByAmtrak:GetoffatBackBayStation.Hotelis3blocksaway.Taxi-around$25.00(or
moredependingontraffic).UberorLyft–around$24(ormore,dependingondemand).
DignityUSA2017NationalConferenceRegistrationForm
July6ththroughJuly9th–BostonParkPlazaHotel,50ParkPlaza,Boston
PersonalInformation
Registrant
One:
LastName,FirstName,M.I.
NameonBadge
Registrant
Two:
LastName,FirstName,M.I.
NameonBadge
HomeAddress,City,State,Zip
PrimaryPhoneNumber
PrimaryEmailAddress
OtherContactMethod(optional)
Chapter,CaucusorOrganizationAffiliation(optional)
Pronouns(optional)
Totals:Pleaseindicateyourchoicesandthenputtheamountinthecolumn.Ifyouareregisteringtwopeople,please
circleasmanyregistrationtypesasneededandindicatethetotalamountforbothpeople.
ConferenceRegistration
$
Pre-Registration-$165(musthavepre-paid$100deposit)
Early-$295Member/$370Non-Member
Regular-$310Member/$385Non-Member
Late-$340Member/$415Non-Member
YoungAdult-$175
SpecialFirstTimeAttendees-$265
SingleDayEvent
$
(Pleasecirclechoice)
Friday(includeskeynotebyRev.PamelaLightseyand1workshopsession)-$125
Saturday (includes plenary panel, two workshop sessions, President’s Luncheon,
dance)-$140
SaturdayDanceonly-$35
SundayBrunchandCommissioningonly-$65
SponsorshipOpportunities
Plenary-$2,000Keynote,$1,500PlenaryPanel,or$500PanelSpeakerWorkshop
Sessions-$300persession(domesticpresenter)or$1,000persession
(internationalpresenter)
OpeningCeremonies-$500
Pre-ConferenceLeadershipSeminar-$500
Chapel-$200
MusicforChoir-$300
Liturgy-$200
FlowersforConference-$50
SaturdayDance-$500
$
SundayCommissioningBrunch-$500
ScholarshiporOtherContributions(anyamountwelcome)
_____Checkhereifyouwantyourcontributiontobeanonymous.
Acknowledgement/Dedication:Pleasespecifyhowyouwouldlikeyour
sponsorshiptobelistedintheprogrambook.
DisplayAds
$
FullPage-$500
HalfPage-$250
QuarterPage-$150
EighthPage-$100
GreetingListing-$25(Nameandmessagenomorethan50characters,
includingspaces)
$ BostonHarborSunsetCruise-$65perperson.
Indicatethenumberofpeople_____
$
ConferenceLogoItems(indicatenumberofitemsbeforethesize)
$
BistroMug-$10Indicatequantity____
ShortsleeveT-shirt-$15Indicatequantity:S___M___L___XL___XXL___
XXXL___
LongsleeveT-shirt-$20Indicatequantity:S___M___L___XL___XXL___
XXXL___
PoloShirt-$30Indicatequantity:S___M___L___XL___XXL___
XXXL___
HoodedZipsweat-$45Indicatequantity:S___M___L___XL___XXL___
XXXL___
TotalAmount
$
AmountandMethodofPayment
Ifpayingbycheck,pleasemakepaymentto:DignityUSA.
AMEX
Visa
Name(asitappearsonthecard)
CreditCardNumber
MC
Signature
Addressifdifferentthanmailingaddress:
Amounttobebilled
ExpirationDate
Discover
SecurityCode
VolunteerOpportunities:
DignityUSAappreciatestheassistanceofvolunteerswhohelptomakeourconventionanenjoyableandwelcoming
experienceforall.Pleaseindicatethingsyoumaybewillingtodotohelpoutbeforeandduringourgathering,and
ourVolunteerorLiturgyCoordinatorwillbeintouchwithyouaroundtheendofJunewithfurtherdetails.Thankyou
foryourhelp!
Pre-Conference:Weds.July5–Thurs.July6
___RegistrationPreparation___RegistrationTable(Weds4-8PM)___SetupforLeadershipTraining(early
morningThurs)
Conference
___Providedirectionstobreakoutrooms___Speakerhospitality___Registrationtable___Meetingroom
assistance(distributingmaterials)____Photography
Liturgy/WorshipSupport:
___Setup___Cleanup___EucharisticMinister___Liturgicalmovement/dance___Reader
___Choirmember.Voicepart_____________________Instrumentalist.Instrument:_______________________
ScholarshipAssistanceisavailable.RequestsmustbesubmittedbyApril1,2017.
SpecialNeeds–Pleasedescribeanydisability(ADA)requirementsorspecialneedsyoumayhave,including
mobilityrestrictions,requestsforsignlanguage,dietaryrestrictions,orchildcare.
Children–Aspecialrateof$75perchild12andunderisavailable.Contacttheofficeformoreinformation.
SpecialEvents:
LeadershipSeminar–FreetoAll,butrequiresregistration
Iwishtoattend_____________
SaturdayEveningDinner:I’dliketojointhefollowinggroup:
____DefendersLeather/LeviCaucus
____TransgenderSupportCaucus
____WomenofDignity
____YoungAdults
____Interestedinbeingpartofanothergroupthatmayform(pleaseinquire
atregistrationtable)
Numberofpeople___________
Othercomments/questions(wewilldoourbesttorespondinatimelyway):
Mailcompletedformto:DignityUSA2017Conference
P.O.Box376
Medford,MA02155OrFax:781-397-0584
Forquestionsorassistance,pleasecontacttheDignityUSAofficeat1-800-877-8797orinfo@dignityusa.org.
ForonlineinformationabouttheConferencevisithttps://conf2017.dignityusa.org/.