South Central NYLA Conference 2025

HOW WOULD YOU LIKE TO REGISTER?*

Individual Registration

$100.00

Individual and Spouse Registration

$150.00

Small Group Registration (3-5)

$300.00

Large Group Registration (6+)

$500.00

Enter coupon

Total

$0.00

Name:*

First NameLast Name

Spouse's Name

First NameLast Name

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Church*

Are you the Youth Pastor or Primary Youth Leader at your Church?*

YesNo

State/District*

Please List Team Members Attending

For questions regarding this form or details regarding the NYLA Conference, contact our office at jbrockman@churchofgod.org or 423-478-7222.

We can't wait to see you!