YWC 2017 Conference Registration
Registration form for the Youth Weekend Conference hosted at Christian Believer's Meeting, Flushing New York from April 14 - 16
Email address *
Step One: Personal Information
First Name *
Your answer
Last Name *
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Grade Level *
City *
Your answer
State/Province *
Primary Telephone *
Your answer
Emergency Contact person *
Your answer
Emergency Contact Phone *
Your answer
Fellowship
Indicate the name and/or locale of the fellowship that you meet with (i.e. Flushing, Richmond, etc.)
Your answer
Chaperone
If you are under the age of 18, traveling out-of-state and require housing, please indicate the chaperone or group leader you will be traveling with for the duration of the conference.
Your answer
Step Two: Dates of Attendance
To help us facilitate the planning of housing and meals, please be sure to check all that apply.

Note: Before filling out this section, please take into consideration the following points.
1) Housing will be provided by local brothers and sisters who are graciously opening their homes for conference-goers. However, due to scheduling constraints, we will only be able to provide housing for Thursday (the night before the conference), Friday and Saturday nights. We will only be able to accomodate those wishing to arrive earlier or later than the conference dates for emergency purposes (to be indicated in the comments section).

2) Also due to time constraints, we will not be able to accept requests for housing mates.

Attendance *
Which dates do you plan on attending? (If you will be attending the entire conference, check all three boxes.)
Required
Housing *
Do you need evening housing arrangements? If no, please check the "None" box. (If there is need for additional housing after the conference, indicate in the comments section.)
Required
Meals *
Which meals do you plan on attending? (Breakfast will be served by the host families.)
Required
Step Three: Transportation
Transportation *
Do you need transportation assistance?
Travel Plans
If yes, please indicate your travel plans (Please be specific, e.g. “I arrive on United Flight 98 at 10:00AM at JFK")
Your answer
Step Four: Medical Information
Please be as specific as possible
Medical Concerns
Medical conditions, including dietary needs, allergies, etc?
Your answer
Step Five: Comments
Comments
Is there anything else you would like us to know? Do you have any special requests?
Your answer
A copy of your responses will be emailed to the address you provided.
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