Region 4 Mini COCAcon Registration

February 6-8, 2025 at Camp Kamassa
4002 Sumrall Rd, Crystal Springs, MS 39059

Friday, February 6:  Arrival time- 2-4pm

Sunday, February 8 : Departure time- 10am

Registration is $186 per person, which includes all meals (Friday dinner, 3 meals Saturday and Sunday breakfast) and snacks and drinks. Camp Kamassa will NOT be able to provide linens, towels, and pillows if needed. Transportation to and from the airport will not be provided.

All registrations and payments must be complete by January 25, 2025. If you are sending a check, please make it payable to COCA and mail it to: 261 Magnolia Crest, Dadeville, AL  36853. Please memo: Region 4 Mini COCA Conference.

For specific questions about the Mini COCAcon schedule or location, contact Jamie Ekstrom, Region 4 Director, at jamie@mycampsunshine.org. For questions regarding payment, please contact COCA Executive Director, Jennifer Amundsen, jennifer.amundsen@cocai.org.

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Region 4 Mini COCAcon at Camp Kamassa, Feb 6-8

Please have every person you are registering fill out the following Participant Release Form, and email them to Callie Campbell, COCA Program Manager, at callie@cocai.org

Name *

First

Last

COCA Member Camp *

Email *

Phone

Address

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

What is the total # of people your Camp is registering to attend this Regional Mini COCAcon? (please include yourself)

If you are paying for multiple attendees, please list all names and corresponding emails

How many people in your group have dietary restrictions?

Please select those dietary restrictions

• None
• Vegan
• Vegetarian
• Gluten Free
• Lactose Free

Does your group plan to drive or are you flying?

• Drive
• Fly

Would anyone in your group like to speak on a particular topic?

• No
• Yes

What topic(s) would you like to speak about?

Would anyone in your group like to facilitate a discussion about a certain topic?

• No
• Yes

What topic(s) would you like to facilitate a discussion about?

# COCAcon? of

What topics are your camp interested in learning more about?

The total # of people I am registering is:

Payment Amount ($186 per person) *

Payment Method *

• Pay by Check, due by January 10. Make payable to COCA and mail to: COCA, C/O Jennifer Amundsen, 261 Magnolia Crest, Dadeville, AL 36853
• Pay Online Below

Payment Method

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