Youth Convention Online Registration
Please fill in the form below. We'll contact you as soon as possible.
Full Name
*
First Name
Surname
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Camper Information
*
Full Camper
Half Camper (Private Accommodation)
Day visitor
District?
*
Please Select
Lowveld
Highveld
Shalom
other
Youth Leader/ Elder/ Director's name
*
ex: Xolile Shongwe
Back
Next
Save
Registration fee: R550 (including accommodation) Daily visitors: R180 Banking details Bank: Capitec Account number: 2407610276 Branch Code: 470010 Ref: LYC/ Initials & Surname Submit proof of payment here:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Save
Submit Form
Should be Empty: