YAYAM Summit 2019: It Takes a Tribe

I am registering as a(n):*

Individual
Couple
Family

Name*

Date of Birth*

Gender*

Male
Female

Email*

Confirm Email*

Cell Phone*

Address*

Dietary Restrictions

Vegetarian
Vegan
Gluten free
Lactose Intolerant
Allergies

Which ministry/department do you represent:*

Which Sub Region do you represent?*

What inspires you to serve in your public role?*

What is the greatest challenge you face as a young leader?*

What are you most looking forward to at the Summit?*

I’m grateful for YAYAM’s willingness to cover 50-100% of my/my families registration fee, but I would like to help pay a portion of the fee.

Amount

$

Coupon Code

Total

$0.00

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