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Youth Convention | June 29 - July 6, 2025

189 Sandhill Hulett Rd., Villa Rica, GA 30180

PERSONAL INFORMATION

First name

Last name

Birthday

Month

Day

Year

This event is for 12 years or older.

Address

Phone

Add country area code (example +1)

EMERGENCY CONTACT

Parent, guardian, etc.

Name

Phone

Add country area code (example +1)

City, State

MEDICAL HISTORY

List any medications you take

List any allergies (including food allergies)

Physical difficulties that we should be aware of

PARTICIPANT’S AGREEMENT

Please read the Conduct Guidelines before signing below.

I agree to respect those in responsibility, to do my part in fulfilling the purpose of this convention, and to abide by the Conduct Guidelines at all times. I understand that should I fail to do so, I will be sent home at my expense and will forfeit all registration fees.

Full name

Date signed/submitted

Month

Day

Year

By checking this box you agree to electronic signature

PLEASE WRITE A SHORT DESCRIPTION OF WHY YOU WOULD LIKE TO ATTEND THIS CONVENTION.

FINANCIAL INFORMATION

Cost, including food, activities, and lodging for the youth convention program, is USD $350 with an early bird’s 10% off ( $315) before June 1. You may include payment in full with this form or pay the remainder upon arrival at the youth convention. (Check the box that applies)

Pricing

Entire Time $315 (discount ends 6/1/25)

Thu-Sun $150

Fri- Sun $85

Sibling discount available. Please call for more information.

2 siblings: $600 ($300 for each)

3 siblings: $825 ($275 for each)

(540) 520-2069 | (352) 345-0444 | (646) 704-2256 | (209) 283-0198

If making payment online please include full name along with payment. Failure to do so may result in money being lost.

Payment Options

Online Payment (Zelle: susftreasurer@gmail.com)

Pay in Person (cash or check)

If making payment online please include full name along with payment. Failure to do so may result in money being lost.

If I elect to make payment via an online method, I hereby agree to provide my full legal name along with the payment submission. I further acknowledge and agree that, should I fail to include my full name as required, any funds remitted may be deemed forfeited and non-recoverable.

PARENT’S AUTHORIZATION

If you are under the age of 18, a parent must sign. If 18 or older, please sign yourself.

Parent's Signature

By checking this box you agree to electronic signature

Date signed/submitted

Month

Day

Year