It's time for Youth Convention 2010 NEXT

All students 6th-12th grade are invited to 2010 NEXTApril 1-3 in Hershey, PA.  Trip cost is $90 plus cost for food (5 meals, est. $40).  $60 deposit due by March 7.  Parent chaperones needed - please contact Jason Knechel for more details (jason@getvictory.net , 484-753-2105).

Please fill out the registration information below.  Once you submit the form, you will be directed to the payment page.  Please be sure to enter YOUTH CONVENTION REGISTRATION in the Designation field to see to it that your payment is properly processed.  Thank you!

YOUTH ATTENDING
Name:     Age:    Grade: 
Name:     Age:    Grade: 
Name:     Age:    Grade: 

Address:


                                            Phone: 

Parent/Guardian Name (required):  

Parent/Guardian Phone (required): 

                  Parent/Guardian Email: 

PLEASE BE SURE TO ENTER "YOUTH CONVENTION REGISTRATION"
IN THE "DESIGNATION" FIELD ON THE FOLLOWING PAGE.  THANK YOU!