Early Registration Form – AG National Young Adults & Youth Ministry

Step 1 of 5 – Lodging Selection + Registration Type

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Individual

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Group

Registration Type(Required)

Individual — I am registering myself only

Group — I am registering myself and others, or registering others only

How will you be attending?(Required)

Full Lodging — Hotel — I will be staying at the convention hotel

Local Resident — Commuter — I will be driving in each day. No hotel needed.

Full Lodging — Hotel — You will be staying at the convention hotel. Room and pricing selection will follow.

Local Resident — Commuter — You will be driving in each day. No hotel stay needed. The commuter fee is $150.

Are you staying for the full convention?(Required)

Yes

The full convention runs Monday July 27th through Friday July 31st.

What day are you attending?

Monday, July 27th

Tuesday, July 28th

Wednesday, July 29th

Thursday, July 30th

Room Rate Selection

The rate you select reflects how many people share a room — not the size of your group. Enter how many people from your group are paying at each rate. Prices shown are per person.

For example, if 4 people in your group are all sharing a 4-person room, enter 4 under the 4-person rate. A Single Room means one person in their own room — it is still part of your group registration.

Early Registration Pricing — Prices will increase after the early registration deadline.

4-Person Room — $325 per person Quantity

Price: $325.00

Quantity

3-Person Room — $375 per person Quantity

Price: $375.00

Quantity

2-Person Room — $470 per person Quantity

Price: $470.00

Quantity

Single Room — $760 per person Quantity

Price: $760.00

Quantity

Individual Hotel Room Rate

Choose Your Room Rate & Type(Required)

4-person room — $325 per person

3-person room — $375 per person

2-person room — $470 per person

Single room — $760 per person

Select the room type that applies to you. The price shown is per person. More people sharing a room means a lower price per person.

Early registration pricing — prices will increase after the early registration deadline.

Commuter Registration

Commuter Registration Fee

Price:

Group Commuter Registration

Group Commuter Registration Fee Quantity

Price: $150.00

Quantity

What is your room type?(Required)

4-Person Room

3-Person Room

2-Person Room

Single Room

Registrant Name(Required)

First Last

Registrant Email(Required)

Registrant Phone Number(Required)

Church, Organization, or Group Name(Required)

Church City(Required)

Church State(Required)

Gender(Required)

Female

Male

T-Shirt Size(Required)

Age Range(Required)

Under 18

18-22

23-34

35-44

45-54

55-64

65 or Above

Prefer Not to Answer

Which best describes you?(Required)

Young Adult (23+)

Youth

Pastor

Other Leader / Parent

Education Level

Career / Profession

Dietary Restrictions / Medical Notes

Let us know of any dietary restrictions, allergies, or medical conditions we should be aware of. Enter “None” if not applicable.

Emergency Contact Name(Required)

First Last

Emergency Contact Phone(Required)

Relationship to Emergency Contact(Required)

Parent

Guardian

Sibling

Spouse

Pastor / Youth Leader

Other

Add each attendee in your group below.
Click Add Attendee for each additional person and fill in their details. Everyone in your group must be listed before proceeding.

Your Room Assignment(Required)

Group – Room A

Group – Room B

Group – Room C

Group – Room D

I am paying for a Single Room

Other

Assign yourself a room label — for example, Room A. Anyone you add in the next step who will be sharing your room should be given the same label. If you are the only person in your room, you can leave this as is or create your own label.

Group Attendees

Name	Email	Phone	Gender	Which best describes you?	T-Shirt Size	Dietary Restrictions/Medical Notes	Actions

There are no Attendees.

Maximum number of attendees reached.

How would you like to pay?(Required)

Pay by Credit/Debit Card

Pay by Zelle

Pay with Installments

Total