Encounter Youth Conference Registration 2021
Date: July 31, 2021
Beginning at 9am
Abundant Faith Christian Center
2525 Taylor Ave, Springfield, IL 62703
For questions, contact Courtney Dandridge at
First Name (of Participant)
Last Name (of Participant)
Date of Birth (of Participant)
What grade will the participant be going into?
Emergency Contact First and Last Name and Relation to Participant (Example: Courtney Dandridge - Mom)
Emergency Contact Phone Number
Does the participant have any Dietary Restrictions and/or Allergies (use N/A if there are no Dietary Restrictions or Allergies)?
Who Will Pick up the Participant (First and Last Name, Phone Number)?
Participant T-Shirt Size
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