YEC Registration

Fill out the form below to register for the 2018 Youth Evangelism Conference to be November 18-19 at the Rapides Coliseum in Alexandria, LA. The cost for this event is $75 and includes conference registration, food, lodging and travel. After completing the form, turn in your payment to the church office or Haven. and you will be registered!
Please complete this form in its entirety.
NAME
PHONE
EMAIL
Date of Birth
Parents/Guardians
Parent's Phone Number
Emergency Contact (Other than Parents)
Emergency Contact Phone Number
Medical Information (Type "None" if there are no medical issues)
I give permission for my child to take part in 2018 Youth Evangelism Conference and to seek help for my child in an emergency. By typing my name below, I understand that I am signing this form.
Submit
If you have questions, you can contact us in the following ways:

Phone

985.345.4990

Email

[email protected]

Address

401 W. Morris Ave.