Please submit one form per attendee.

Section One - Personal Information

Please provide your personal information for honoraria and registration purposes if you are a K’ómoks member that is aged 16 and older.

Full Name *

Age *

Elder (55+)
Adult (16 - 54)
Youth (0 - 15)

Email *

Address (if changed since last Quarterly)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Section Two - Event Registration

Would you like to register for the KPA on Saturday, March 14 and Sunday, March 15? *

Yes
No

When would you like to register for? (Please select all that apply)

How would you like to attend? *

In Person
Zoom
Other

If other, please explain:

Do you plan to bring a guest that is not registered *

Yes
No
Other

If other, please explain:

Will you be traveling from out of town and need a travel reimbursement? *

Yes - Please continue to section three
No - please continue to section six

Section Three - Travel Information

Please fill out if you are traveling from out of town to the Comox Valley for the KPA. Members must choose the least expensive form of travel possible.

Receipts are required for all expenses to be claimed. Please send all receipts for travel to communications@komoks.ca.

If you do not need travel reimbursement, please continue to section six.

Meal Expenses (Please select all that apply)

TO - Breakfast (if traveling before 7 am)
TO - Lunch (if traveling between 7am and 6:30pm)
TO - Dinner (if traveling after 6:30pm)
FROM - Breakfast (if traveling before 7 am)
FROM - Lunch (if traveling between 7am and 6:30pm)
FROM - Dinner (if traveling after 6:30pm)

Accommodations

I would like a room at the Bayview Hotel
I booked my own accommodations
I have private accommodations (ex. staying with family)

Transportation

I am traveling within Vancouver Island
I am traveling from the Mainland
I am flying to Comox

Section Four - Travel Expense: Milage & Ferry

Please fill out if you are using the ferry for travelling to the KPA and this was the least expensive option of travel possible.

Receipts are required for all expenses to be claimed. Please upload all receipts for travel or send them to communications@komoks.ca.

If you do not need travel reimbursement, please continue to section six.

Departure from Home to arrival in Comox

Please calculate and include the total driving distance in kilometers.

To do this:

1. Use Google Maps to find the distance from your hometown to the ferry terminal you will depart from.

2. Then, find the distance from the arrival ferry terminal on Vancouver Island to 3330 Comox Road.

3. Add both distances together to get the total kilometers traveled.

Example:

- Vancouver to Horseshoe Bay ferry terminal = 30 km

- Departure Bay (Nanaimo) to 3330 Comox Road = 116 km

- Total distance: 30 km + 116 km = 146 km

Which ferry route will you be taking from home to Comox?

What is your total milage from home to Comox?

Departure from Comox to arrival at Home

Please calculate and include the total driving distance in kilometers.

To do this:

1. Use Google Maps to find the distance from 3330 Comox Rd to the ferry terminal you will depart from.

2. Then find the distance from the arrival ferry terminal to your home.

3. Add both distances together to get the total kilometers traveled.

Example:

- 3330 Comox Rd to Departure Bay (Nanaimo) = 116 km

- Horseshoe Bay ferry terminal to Vancouver = 30 km

- Total distance: 116 km + 30 km = 146 km

Which ferry route will you be taking from Comox to home?

Signature you from?

What is your total milage from Comox to home?

Did you prepay for the ferry to and from?

Yes
No

Please upload your ferry receipts here. If you have issues, please email them to communications@komoks.ca.

Drag & Drop Files, Choose Files to Upload You can upload up to 10 files.

Section Five - Travel Expense: Flights

Please fill out if you are flying to the KPA and this was the least expensive option of travel possible.

Receipts are required for all expenses to be claimed. Please upload all receipts for travel or send them to communications@komoks.ca.

If you do not need travel reimbursement, please continue to section six.

Flight Expenses

Please include flight information, airline, and any other booking details needed, including costs.

Please upload your flight receipts here. If you have issues, please email them to communications@komoks.ca.

Drag & Drop Files, Choose Files to Upload You can upload up to 10 files.

Section Six - Member Declaration

Declaration *

I, the member, confirm that all information provided above is accurate and complete. Furthermore, I acknowledge and understand that original receipts are required for all expense claims. Reimbursement will not be issued for any expenses for which receipts are not submitted.

Signature *

Clear Signature

Date *