Montreat Youth Conference 2025

Contact Information

Name of Youth

Youth Current Grade (2024-2025 school year)

Name of Parent(s)/Guardian

Contact Email of Parent/Guardian

This address will receive a confirmation email

Parent /Guardian Phone

Emergency Contact Name

Emergency Contact Phone

Health Information

Does your youth have any allergies?

Does your youth have any dietary restrictions?

Does your youth take any prescription drugs? If so please list name, dose, and frequency.

Is there any other medical information relevant for your child? (Lingering injuries, mental health, recent surgeries, ongoing medical issues, etc.)

Health Insurance Company

Policy Number

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

June 8th- June 14th

Early bird registration: $650 if you register before January 1, 2025
Final registration deadline: $700, Registration closes May 1