Western RegionalProfessional Conference2023 Westward Look Wyndham Grand Resort and Spa March 26-28, 2023 Tucson, AZ click here for hotel reservations Western Regional Professional Conference Registration Attendee's Name(Required) First Last Pronouns Attendee's Title(Required) Attendee's Email(Required) Attendee's Mobile Number(Required)Please fill in the name of your JCC(Required) All meals and snacks served during the conference will be Dairy and Vegetarian. The meal at the Tucson JCC will be under Rabbinic supervision. Menus will offer an array of options for varied taste palates and dietary restrictions/ preferences. Please indicate if any of these dietary restrictions apply: Gluten Free Lactose Intolerance Vegan Vegetarian Food Allergy (please identify) Kosher Meal Request Select AllFood Allergy Please choose from one of the following cohorts(Required)Sports, Fitness and AquaticsYouth and Teen + After School + Day CampOvernight CampEarly Childhood + Young Family Engagement + PJ LibraryFacilitiesHRInclusion – Serving People with DisabilitiesFinanceMarketingMembership/Guest Services + Community EngagementAdult Program + Arts and Culture + Jewish LearningPhilanthropyCOO/AEDCEOAbout mePlease answer the following I like to watch sports I enjoy playing sports I have a yoga/meditation practice I enjoy musical theater I am a visual artist I enjoy going dancing I am a musician I enjoy reading What kind of books Favorite musical artist Which are your three favorite types of food Mexican Chinese Italian Ethiopian Veg/Vegan Middle Eastern American I have a Cat Dog Media Release(Required)I hereby give permission as an attendee of the JCC Western Regional Professional Conference be photographed or recorded and for the photos, videos or quotes to be used in educational and/or promotional materials that include and are not limited to the internet, produced by Tucson JCC or their agents. Further I understand that there will be no compensation for the use of these photos, videos or quotes. I have read and accept the Tucson JCC Media ReleaseBy clicking submit you agree that your JCC will submit payment.$295 per person (please note the Canadian JCC’s should register and send a check to the Tucson JCC)Payment MethodCredit Card (Visa, MasterCard, Discover)Credit CardWe do not accept American ExpressName on Card(Required) First Last Billing Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Card #(Required) Exp(Required) CVC(Required) (3-digit code on back of card)
