Youth Convention 2021
Fill out the following form to sign your student up for Youth Convention 2021 on October 22-23! After filling out this form, please ensure you make the payment via cash, check or Zelle (sent to admin@hopechapelglendale.com w/ student's name + youth convention in the memo). Payment structure: $55 if registered by 9/22/21. $60 from 9/23/21-10/6/21. $65 from 10/7/21-10/17/21.
Student's Name
First Name
Last Name
Student's Grade
Please Select
7th Grade
8th Grade
Freshman (9th)
Sophomore (10th)
Junior (11th)
Senior (12th)
Student's Phone
Please enter a valid phone number.
Parent/Guardian Name
First Name
Last Name
Parent/Guardian Phone Number
Please enter a valid phone number.
Parent/Guardian Email Address
example@example.com
Please select the overnight option you prefer:
My student can spend the night at Hope Chapel (this will be chaperoned and students will be separated by gender)
I prefer to pick my student up and drop them back off in the morning before the group leaves
Other
Please list any food allergies your student has:
Please list any medication your student will bring (if staying overnight):
Payment Option
I have already paid for my student
I will pay via cash
I will pay via check
I will pay digitally via Zelle
Other
Submit
Should be Empty: