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Motion17
MOTION is a student conference that is founded on the belief that our faith is not meant to be idle, hidden, or contained but instead lived out in MOTION in Christ! We want to see this generation empowered by Jesus, equipped to make a difference, and living out their faith every day!

When: July 27-29
Where: Birmingham, AL
Cost: $175.00 (Conference Ticket, Travel, Rooming, 2 meals) *Price increases to $200 after 3/20.

Student Information
First Name
Your answer
Last Name
Your answer
Cell Phone Number
(555) 555-5555
Your answer
Gender
Age
Your answer
Grade
Roommate Preference 1
This is not a guarantee, but a preference to help to take into consideration in rooming assignments.
Your answer
Allergies/Medical Concerns
Please list any medications you are taking, food allergies you may have, or any other medical concerns we need to know about
Your answer
Parent Information
First Name
Your answer
Last Name
Your answer
Relationship to Student
(Parent, Guardian, Grandparent)
Your answer
E-mail Address
This is our main way of communication, please use an e-mail that is checked regularly.
Your answer
Cell Phone Number
(555) 555-5555
Your answer
Emergency Contact Name
Leave blank if it is the same as above.
Your answer
Emergency Contact Cell Number
Leave blank if it is the same as above.
Your answer
Does your student have an UPDATED medical release form on file
Required
Parental/Guardian Consent
Required
I understand that my student does not have a spot on the trip until I have paid the $50.00 deposit.
Required
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