Middle School Youth Gathering Registration Form 2025

Friday - Sunday, November 7-9, 2025 | Please fill out this Middle School Youth Gathering Form.

Parents, we can always use help on this amazing trip. Let us know in the form if you are able to help.

November 7-9, 2025
Speaker: Rehema Kavugha
Band: Tribe and Tongue
Cost and Registration: $250.00 until September 21. $280 till September 30 when registration closes)

The 2025 Middle School Youth Gathering will be held at the Lake Yale Baptist Conference Center in Leesburg, Florida.

Youth Name

Grade

Please select one option.

6th 7th 8th

T-shirt Size

Please select one option.

Adult Small Adult Medium Adult Large Adult XL Adult XXL Adult XXXL

Roommate Request (not guaranteed)

Parent Name

Chaparone

Please select one option.

I am not able to go as a parent chaperone. I am willing to go as a parent chaperone and I am willing to drive. I am willing to go as a parent chaperone and I am not able to drive.

Parent Email

This address will receive a confirmation email

Emergency Contact Phone During Event:

Address

Payment

Pay Online with Card ($250.00) Pay $250.00 Cash or Check to Church office (0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Friday - Sunday, November 7-9, 2025

Please fill out this Middle School Youth Gathering Form.

Parents, we can always use help on this amazing trip. Let us know in the form if you are able to help.

Middle School Youth Gathering Registration Form 2025

Description

Please Fix the Following