AWAKEN Youth Conference Registration

June 19, 2021
Grades 7-12
Cost: $10

Registration Type*
- Group
- Individual

Individual Registration
Student's Name
First Last
Student's Email
Grade (Fall 2021)*
Gender*
Parent's Name
First Last
Parent's Email
Individual

Group Leader Information
Group Leader Name*
First Last
Group Leader Email*
Group Leader Phone*
Church Information
Church Name
Church City/State
Attendee Information
Enter the number of attendees for each category
Students (Girls)
Students (Guys)
Adult Sponsors

Payment Information
AWAKEN Registrations
Price: $10.00
Promo Code
Total
$0.00
Payment Options*
- Pay Now with Credit Card
- Pay Later
Credit Card

Card Details

Cardholder Name