Illinois State Youth Convention
November 6-8 - 2026
Church Name
*
Group Leader
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Number of People Registering as a Group
*
Please list all names of students and adults attending. Signify ADULTS with an *
*
T-Shirt for everyone that registers
*
Rows
How Many?
Small
Medium
Large
X Large
XX Large
XXX Large
4 X Large
Registration Fee per person
prev
next
( X )
Total Registration
Per person attending including adults
$50.00
$
50.00
Quantity
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30
Debit or Credit Card
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
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Should be Empty: