99th Annual NFB of Iowa State Convention Registration

National Federation of the Blind of Iowa State Convention

October 17-19, 2025

Holiday Inn and Suites Northwest

4800 Merle Hay Road., Urbandale IA 50322

Welcome! We are so pleased that you will be joining us.

If you have any questions or need assistance, please contact President Helen Mejia at hmejia@nfbi.org or (570) 983-7867. We look forward to seeing everyone soon!

If you are registering multiple attendees, please remember that a separate registration form must be completed for each person to ensure accurate processing. For the best experience, especially if you use a screen reader, we recommend using the arrow keys to navigate the registration form smoothly.

Convention Registration

First Name *

Last Name *

Street Address *

Supplemental Address 1

City *

State *

Postal Code *

Country *

PHONE #: (Used for contact, enter numbers only) *

Email Address *

Preferred Agenda Type *

Braille Large Print Electronic

Are you a current dues paying member of a Chapter/Division of the National Federation of the Blind of Iowa? *

Yes No

This means paying dues during the current calendar year for at least one of the NFBI chapters or divisions. This is not the same as being a member of our tall-corn mailing list.

If yes, what chapter do you belong to? *

Are you blind or low vision? *

Yes No

Are you the parent of a blind/low vision child? *

Yes No

Are you a blindness professional? *

Yes No

Are you a student? *

Yes No

Are you a blind parent? *

Yes No

Are you a guide dog user? *

Yes No

Would you like us to add your email to our tall-corn mailing list? *

Yes No

Please select your age bracket *

Under 18 18-30 31-50 51-65 66+

Do you need child care in order to be able to participate in the convention? *

Yes No It would be nice but is not essential

Do you have any medical or religious dietary needs for Convention meals? If you choose yes, someone will follow up with you for specifics. *

Yes No

General Release of Liability and Hold Harmless Agreement:

By checking the checkbox below, 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 Iowa. 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 and Hold Harmless Agreement *

I accept

Media Release Agreement

By checking the checkbox below, 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 Iowa (NFBI) 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 Iowa. 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 NFBI.

Media Release Agreement *

I accept

Code of Conduct Agreement

By checking the checkbox below, 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

2025 NFB of Iowa State Convention

99th Annual NFB of Iowa State Convention Registration

Welcome! We are so pleased that you will be joining us.

General Release of Liability and Hold Harmless Agreement:

Media Release Agreement

Code of Conduct Agreement

Registration Fees & Checkout:

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