Boston ICDA-US 2023 Combo Registration

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Street Address or P.O Box REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Email REQUIRED Please fill out this field. Please enter an email address.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Which of the following is your phone number? Video Phone Cell / Smart Phone Voice

Are you a member of ICDA? REQUIRED Yes No Please fill out this field.

What is your ICDA Chapter? Please enter valid data.

If you are a delegate or a moderator for ICDA-US Chapter, please check the box below: Delegate Moderator

Are you a Pastoral Worker? REQUIRED Yes No Please fill out this field.

Please check one that you are ... REQUIRED Deaf Hearing Deaf-Blind Please fill out this field.

For Deaf-Blind accessibility, please email 2023BICDAConf@bostondeafcatholic.org by May 1, 2023.

Communication Needs (ASL/English interpreters will be provided) Assistive Listening Device Tactile Interpreting Close-vision intrepreting

Special Dietary Needs (we can not guarantee all needs can be met but will do our best) Diabetic Vegetarian Gluten Free Lactose Intolerant Other...

If you check "Other..." above, please specify Please enter valid data.

Are you interested in going to the Red Sox game at Fenway Park on Thursday evening, July 6th? Tickets will be on sale next month as a separate payment. We will contact you. REQUIRED Yes No Please fill out this field.

Payment Options: REQUIRED Please fill out this field.

If you select to send a check by mail, you make the check payable to: ICDA Boston Chapter 5. Then mail it to the following address:

ICDA Boston Chapter 5
St. Jude's Parish
147 Main Street
Waltham, MA 02453

I agree that registration for ICDA-US Boston 2023: FaithStrong - "Be Not Afraid" is non-refundable unless the event is canceled by the Westin Boston Seaport District Hotel.* Please select this field.

Boston Deaf Apostolate

Archdiocese of Boston
Boston, Massachusetts

Boston ICDA-US 2023 Combo Registration