Young People Conference Registration Form
Which Conference are you registering for? *
First & Last Name *
Name of person being registered
Your answer
Grade/Status *
Gender *
Email Address *
Use parent's if you don't have one
Your answer
Cell Phone *
Use parent's if you don't have one
Your answer
Parent Name *
Use exact name that appears on credit card
Your answer
Parent Email *
Your answer
Parent Cell Phone *
Your answer
When is the earliest that you can leave Irvine on Friday? *
Time
:
Allergies or Dietary restrictions?
Please also include any questions or comments here
Your answer
Method of Payment *
For online payment please use this link: http://www.irvineyp.com/apps/webstore/products
Conference Rules & Regulations *
Required
Comments
Your answer
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