summit 2023 payment page

Name*

First Last

Email*

Cell Phone (for conference related questions)*

Payment

Registration Fee*

This includes: conference sessions, meals, and special programs, and a hotel room on Monday evening May 1 (your own room). Please note that this conference is highly subsidized by the OU Women's Initiative.

Standard Fee - $425.00
I will share a room with a friend Monday evening for a discounted rate of $375.00
I will not be staying at the hotel on Monday evening - $350.00

Name of friend:*

Please note: you and your friend must submit your payment forms within 5 business days of each other in order to secure your room and discounted rate.

Coupon code (staff)

Sunday evening April 30*

We welcome you to join us at the hotel on Sunday evening beginning at approximately 7:00 PM. We will provide a light boxed dinner. The additional cost is $200.

I will arrive Monday morning at the beginning of the conference (I am not staying over Sunday evening).
I would like to arrive on Sunday evening April 30, for an additional $200.

I will join you on:*

Monday
Tuesday

Total

$0.00

Hidden

Please click here so that you receive all necessary conference information.

Yes, I would like to subscribe

Consent*

I understand that if this reservation is canceled before April 19, 2023, 50% of the fee is refundable. Beginning April 20, 2023, no part of this fee is refundable.

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Conference Directory

We plan to share a directory of conference participants (printed or emailed PDF, not posted online) which will serve as a valuable resource for you to network with women involved in similar communal work. Please enter the information below that you would like printed in the directory. Please check that all spelling and contact information is correct.

Name

First Last

Email

Phone

Address

City State / Province / Region Country

Areas of communal involvement (written in list form)

Thumbnail picture

It would be great if you could upload a picture so that women can put a face to a name.

Max. file size: 512 MB.

Lay and Professional Positions

Please list up to 5 items in the following format: Lay and/or professional role, Organization / company

Micro Sessions

One of our networking discussions will center around navigating leadership challenges together. Are you currently facing a challenge you would like to discuss in a small group setting?

Please provide a brief description of your challenge.

Additional Comments

Comments:

OU consent

ORTHODOX UNION MEDIA RELEASE*

From time to time, The Union of Orthodox Jewish Congregations of America, and its programs, employees and agents (together, the “Orthodox Union”) take photographs and videos of individuals, including minors, who attend or participate in Orthodox Union events, programs, and other offerings. The Orthodox Union engages in these activities for purposes relating to the advancement of the religious, spiritual, charitable, and educational goals and objectives of the Orthodox Union, including but not limited to the sharing of photos/videos in newsletters, on our blogs, and on our website and social media pages for the purpose of keeping our members and others informed of the Orthodox Union’s events and other activities. Please complete this form to give us permission to take photos/videos of you and/or your children when you participate in Orthodox Union events or programs and to use those photos/videos in our printed and online publicity:

I hereby authorize the Orthodox Union to take photographs and/or video of me (or my children) when I (or my children) participate at Orthodox Union events or programs. I grant the Orthodox Union full rights to use and share the images resulting from the photographs and/or videos and any reproductions thereof (the “Recording”), in whole or in part, along with my (or my children’s) name, biographical information and quotations for any purpose including fundraising, publicity, advertising, or on social media, all without further obligation or compensation. I hereby waive any right of review or approval regarding the Recording and the Orthodox Union shall have the right to edit or delete the Recording in its sole discretion. I understand that all rights in and to the Recording shall be the Orthodox Union’s sole and absolute property. I understand that if I access the Orthodox Union’s services through a third party platform, product, service, or application (a “Third Party Service”), content and related information generated while accessing OU’s services in this manner may be monitored, captured, and or recorded by the third parties that provide such Third Party Services. I consent to the use and sharing of personal information by any such third party as described in the privacy policy available through the Third Party Service. I release and forever discharge the Orthodox Union from all causes of action, suits, or liability of any kind arising from or in connection with the use or publication of any Recording of me or my children made in connection with my participation in Orthodox Union events. I waive any right of privacy associated with the Recording and I waive any right to compensation related to the use of the Recording.
I HAVE READ THIS AGREEMENT AND AM FULLY AWARE OF ITS CONTENTS, INCLUDING THE RELEASE THAT I HAVE AGREED TO HEREIN.
I warrant that I am at least eighteen years of age (or, if not, that my parent or legal guardian has agreed to the foregoing and signed below) and that I have the full and unrestricted authority to enter into a contract for myself (or, if not, that my parent or legal guardian has agreed to the foregoing and signed below).
If any provision of this agreement is held to be unenforceable, the remainder of it shall continue to be in full force and effect.
This waiver shall remain in effect until such time as I advise the OU otherwise in writing.

I acknowledge and represent that I am at least eighteen (18) years of age and that I have read the foregoing TERMS OF CONTEST, & THE ORTHODOX UNION MEDIA RELEASE, and that I understand it and sign it voluntarily. By signing below I agree to both - followed by parents' electronic signature.
Printed Name *
By typing my name here, I am signing this form electronically and I agree that this electronic signature is the equivalent of my manual signature on this form.
Email *
Phone *
Address *
- Same as address above
Date: 04/19/2024