Southeast NYLA Conference 2026

Individual Registration

$100.00

Individual and Spouse Registration

$150.00

Small Group Registration (3-5)

$300.00

Large Group Registration (6+)

$500.00

Enter coupon

Total

Name:

First NameLast Name

Spouse's Name

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Format: (000) 000-0000.

Church

Are you the Youth Pastor or Primary Youth Leader at your Church?

State/District

Please List Team Members Attending

For questions regarding this form or details regarding the NYLA Conference, contact our office at jbrockman@churchofgod.org or 423-478-7222.

We can't wait to see you!