National Youth Conference Registration and Payment Form

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EVENT REGISTRATION CLOSES ON July 4th.
Select and donate for events held during the conference as well as your conference fee.
*Please note, events/activities may close before July 4th if capacity is reached.

First Name
Last Name
E-Mail Address
Phone

Conference Fees
▪ National Young People's Department Officials ($250)
▪ Young People Ages 21-35 ($150)
▪ Young People Ages 20 and under ($55)
▪ Mens Department ($50)
▪ Womens Department ($50)

Bus Registration
▪ Headquarters Roundtrip ($140)
▪ Maryland Roundtrip ($90)
▪ Headquarters One-way ($75)
▪ Maryland One-way ($50)

Events $10 Bus fee, if seats are available.
Back In Time: Decade Party - Wednesday, July 15^th (Free) How many "Back In Time" tickets? Between 0 and 50. # Enter the names for each ticket.
Back to School Drive: Community Service - Thursday, July 16^th (Free) (Maximum Capacity Reached) # Enter the names for each ticket.
Norfolk Botanical Gardens - Thursday, July 16^th ($25) How many "Norfolk Botanical Gardens" tickets? Between 0 and 50. $
Annual Outing - Thursday, July 16^th ($40, Ages 4 and older) $ Enter the names for each ticket.
Career Day - Friday, July 17^th (Free) How many "Career Day" tickets? Between 0 and 50. #
Chosen: A Night of Reflection and Light - Saturday, July 18^th ($60 AGES 13 & OLDER) $
Chosen: A Night of Reflection and Light - Saturday, July 18^th ($25 CHILDREN AGES 12 & UNDER) $
Total Donation Amount: $
Additional Comments

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National Youth Conference Registration and Payment Form

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