Registration

We need you to help us with some basic information for your account creation.

Your Full Name

Church Name

Age

Sex

Phone

Email Address

Home Address

Clergy or Not

Yes No

How many Additional family members will attend the conference?

(Exclude yourself. Only 4 adults allowed per room. If your registration accounts for more than 4, please complete this attached form and email: fyc@neamericandiocese.org)

Select number

Use the same Church Name for all the registrants Use the same Phone number for all the registrants Use the same Home address for all the registrants

RATE PER PERSON

$525

people / room

$550

people / room

$600

people / room

$850

person / room

$450

*Minor rate (Ages 4–21) — 4 people per room

*Children 3 and under attend for free.