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Youth Workers Conference Registration

EARLY BIRD RATES : Adults - $45 | Student Leaders - $25 | Messiah Students - $15
Registration Selection

I am the main contact AND I AM attending the conference
I am the main contact BUT I AM NOT attending the conference

Since you are attending, are you registering as? [Select one]
Adult Leader (Pastor, lay leader, volunteer, social services worker, etc.)
Student Leader (High school age leader in youth ministry)
Messiah College Student
Contact Information
First Name: 
Last Name: 
If you are a Messiah alumnus/a, provide class year: 
Home Street Address: 
Home City: 
Home State: 
Home Zip Code: 
E-mail Address: 
Phone Number: 
Ministry Title or Position: 
Church/Organization Name: 
Church/Organization Street Address: 
Church/Organization City: 
Church/Organization State: 
Church/Organization Zip Code: 
Size of youth group [Senior High age]
Session Information
To help us plan for spacing issues, please indicate the workshop sessions you wish to attend:
Morning Session
Afternoon Session