2023 State Convention Registration Form

This online registration form must be submitted by or before Midnight on February 28, 2023 to get the discounted rates. All registrants will be required to pay a $65 registration fee which includes the cost of a banquet meal and the entry fee for the auction. Please note that all registrations completed after February 28 will incur an additional charge of $10. It is to your advantage to register before February 28, 2023 via the online registration form.

If you are registering multiple people for the convention, you MUST fill out a separate form for each attendee.

If you have any questions, please contact:
Nena Chadwick, President
National Federation of the Blind of Arkansas
Phone: 479-435-8348
Email: nchadwick@nfbar.org

Please notify us of any food allergies/special requests by February 28. We will do what we can to accommodate them.

Upon form submission, you will be redirected to Converge to complete your registration transaction. In any of the fields that requires an amount that you are not paying for at this time, please put in either N/A or 0 in order for your transaction to be completed correctly.

All required fields are marked with a *.

First Name First Name

Last Name Last Name

Street Address Street Address

Address Line 2 Address Line 2

City City

State/Province State/Province

ZIP Code ZIP Code

Phone Number Phone Number

Email Address Email Address

Preferred Agenda Format Preferred Agenda Format

Are you a blindness professional? Are you a blindness professional?

Are you a current dues paying member of the National Federation of the Blind of Arkansas? Are you a current dues paying member of the National Federation of the Blind of Arkansas?

Are you a first time convention attendee? Are you a first time convention attendee?

Are you a guide dog user? Are you a guide dog user?

Event Fees

Convention Registration # $65

General Release of Liability & Hold Harmless Agreement

I agree to assume all risks and to release, hold harmless, and covenant not to sue the National Federation of the Blind or any designated beneficiaries, sponsors, officers, officials, affiliates, chapters, communities, organizations, friends of the event, and all other government or public entities and all their respective directors, officers, agents, employees, and members for any claim, loss, or liability that I may have arising out of my participation in the event. I / My child will participate in the event facilitated by the National Federation of the Blind of Arkansas. I / My child will adhere to any and all rules and policies of the Program. I agree / My child has permission to participate in all activities of the Program.

General Release of Liability & Hold Harmless Agreement

I accept

Media Release

I hereby give permission to photograph me (and my child) and to use audio and/or video equipment to record my participation in the National Federation of the Blind of Arkansas (NFBAR) event. I grant permission to use said photos or recordings to promote the programs of the National Federation of the Blind (NFB) and the National Federation of the Blind of Arkansas. I also understand that print and visual media may be used to distribute information regarding my and/or my child(ren)’s participation in the program. It is understood that this material will be used solely for educational purposes or to promote the programs of the NFB and NFBAR.

Media Release

I accept

NFB Code of Conduct Agreement

I acknowledge that I have read the Code of Conduct of the National Federation of the Blind and that I agree to follow its policies, standards, and principles during this National Federation of the Blind sponsored event. This policy will be enforced during the event.

Code of Conduct Agreement

I accept

2023 State Convention Registration Form

2023 State Convention Registration Form

General Release of Liability & Hold Harmless Agreement

Media Release

NFB Code of Conduct Agreement

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2023 State Convention Registration Form

2023 State Convention Registration Form

General Release of Liability & Hold Harmless Agreement

Media Release

NFB Code of Conduct Agreement

Subscribe to Arkansas Mailing List

Contact Us

Connect with Us

Subscribe to
Arkansas Mailing List