Youth Conference Registration Form

20xx PYA Summer/Winter Conference Registration
City, State
Click for Hotel Reservations
Click for Facebook Event
Full Name
First NameLast Name
Gender
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
Phone Number
Area CodePhone Number
E-mail
Birth Date
MonthDayYear
Chapter Name
Chapter Location
City, State
Emergency Contact Information:
Contact Full Name
First NameLast Name
Contact Phone
Area CodePhone Number
Contact Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
Relationship to Attendee
Flight Arrival at Airport (Airport code)
Arrival Time
Airline(s) & Flight Number(s)
Flight Departure from Airport (Airport Code)
Departure Time
Airline(s) & Flight Number(s)
If you are under 18, please print and sign the text waiver and letter of consent. YOU MUST HAVE THIS SIGNED BY A GUARDIAN PRIOR TO YOUR ARRIVAL. Failure to do so will result in participation REFUSAL. Please print this form, sign it with your guardian, and BRING IT WITH YOU.
If you are 18 or over, you can sign these forms upon arrival.
Click for Waiver
Click for Letter of Consent
Acceptance of Terms
Confirmation
Packages
Packages include airport/event transportation, daytime events/meals, and nighttime events/meals.
Seperate tickets only available for nighttime events. Transportation not included. Welcome night and White Party Greek Night at the door. Panigiri tickets available for pre-purchase and at door.
PACKAGE PRICES WILL BE RAISED JUNE 16TH
Package Options
prevnext( X )
$70 PYA Discounted Member Package + $3 Convenience Fee$73.00

$90 Non-Member Package + $3 Convenience Fee$93.00
Should be Empty:

20xx PYA Summer/Winter Conference Registration

Emergency Contact Information:

Flight Arrival at Airport (Airport code)

Flight Departure from Airport (Airport Code)

If you are under 18, please print and sign the text waiver and letter of consent. YOU MUST HAVE THIS SIGNED BY A GUARDIAN PRIOR TO YOUR ARRIVAL. Failure to do so will result in participation REFUSAL. Please print this form, sign it with your guardian, and BRING IT WITH YOU.

Package Options*

Package Options