Youth Online Registration ->
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Congregation:
Address:
Phone number
Email address
Name (first line) and Roommate (second line)
Male
Female
Sponsor
Jr. High Youth
Sr.
High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
Male Female Sponsor Jr. High Youth Sr. High
If, as a youth, you are lodging with your family, write their names on the roommate line. Your cost is the same as single occupancy because you will
occupy a suite.
Cost
$105 per person, double occupancy
$115 per person, single occupancy
$55 registration, lunch and dinner only (no lodging or breakfasts)
A limited amount of financial aid is available to make your attendance possible. If desired, please contact Jason Gerlach at 540-434-9727 or email him.
# youth
x $105 (dbl) = $
# youth
x $115 (sgl) = $
# youth
x $55 = $
(no lodging/breakfast)
Total: $
Please make payment by check. Deadline is June 27, 2008.
(Don't reset unless you want to erase the form.)
Contact Virginia Mennonite Conference:
Tel: (540) 434-9727 Fax: (540) 434-7627
901 Parkwood Dr., Harrisonburg , VA 22802
info@vmconf.org