YOUTH CONFERENCE 2022 REGISTRATION
Youth Conference will be held this year from June 30 to July 1 at Nichols College in Dudley, MA. All youth ages 14-18 are invited (including those turning 14 in 2022).

Please register as soon as possible, but no later than May 22, 2022. Reach out to Michelle Truax (msjbtruax@gmail.com or 435-862-3408) if you need an exception. Thank you!
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Full Name *
Ward or Branch *
Dietary Restrictions *
I am a/an... *
T-shirt size: *
Youth Phone Number *
Youth Email *
Parent/Guardian Name(s) *
Parent/Guardian Phone Number(s) *
Parent/Guardian Email *
Is your Parent/Guardian your emergency contact? *
If you answered "NO" on the previous question, please fill in an emergency contact name and phone number below:
Who will be dropping you off? *
Who will be picking you up? *
Contact information for pickup person *
The Permission/Medical Release Form must be turned in. Please indicate how you will turn it in: (https://www.churchofjesuschrist.org/bc/content/shared/content/english/pdf/callings/young-men/parental-permission-medical-release.pdf) *
Permission & Medical Release Form Reference (can be downloaded and filled out as well)
Photos taken at Youth Conference 2022 that include me may be posted on the Blackstone Valley Youth Facebook and Instagram Group pages. *
I give permission for my child to be administered over-the-counter medications during Youth Conference: *
I agree to follow the guidelines as outlined in For the Strength of Youth while at Youth Conference (https://www.churchofjesuschrist.org/bc/content/shared/content/english/pdf/ForTheStrengthOfYouth-eng.pdf?lang=eng) *
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