Registrant Information:
First Name:
Last Name:
Preferred Badge Name:

E-Mail:

Street Address:
City:
State:
Zip/ Postal Code:
Home Phone: Cell Phone:
Proper format (xxx) xxx-xxxx

Church (Church & City) :

Registration Category: (select one)

Youth 12-18 Youth 5-11

Current Grade:

Partial Weekend Registration Rates: (choose one)
Select one radio button that corresponds with the day(s) and enter the amount
that corresponds with correct fee category at the bottom of the page.

Friday only:
$45.00 Youth 12-18
$15.00 Youth 5-11

Saturday Only:
$60.00 Youth 12-18
$29.00 Youth 5-11

Sunday Only:
$45.00 Youth 12-18
$15.00 Youth 5-11

Total Amount: Please do not enter a dollar sign
(If you would like to add a donation to your registration fees, you may add the dollar amount here and make a notation in the comments. Otherwise, use the link at the top of the page. Thank you.)

Credit Cards: We accept most major credit cards.
Hit the SUBMIT button to enter your credit card information

To Register hit and fill in your credit card information with our secure payment option

Before hitting submit, please print for your records.

 

HOW TO REGISTER:
Everyone coming to any part of convention must fill out a form
(either Adult or Youth form) ONLY PREPAID RESERVATIONS WILL BE ACCEPTED.
DUE BY NOON, June 2, 2010. NO REFUNDS AFTER June 7, 2010.