The Vine Conference Registration Register for The Vine ConferenceWe will not sell or otherwise disclose to third parties the information you provide via this registration form. Providing contact information will enable us to send you information about our next event or contact you should we have questions about your registration.Registration Type* Individual Registration Group Registration Individual InfoParent Name* First Last Address* Street Address Address Line 2 City AAAEAKALAPARASAZCACOCTDCDEFLFMGAGUHIIAIDILINKSKYLAMAMDMEMHMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRPWRISCSDTNTXUTVAVIVTWAWIWVWY State ZIP Code Cell Phone*Parent's Email*To receive registration confirmation Student's Email*To receive registration confirmation Church InfoChurch*Church Address* Street Address Address Line 2 City AAAEAKALAPARASAZCACOCTDCDEFLFMGAGUHIIAIDILINKSKYLAMAMDMEMHMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRPWRISCSDTNTXUTVAVIVTWAWIWVWY State ZIP Code Church Phone*Church Website Sponsor InfoPlease include all information for all sponsors. Sponsors (List All Sponsors) Cell Phone Email Gender Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Student InfoSr. High Students/Grade*Student NameGradeGenderT-Shirt Size click + to add more/click - to removeSleeping ArrangementsDorms are first come first serve. Once we run out of room, we will ask that you make hotel reservations. Dorm Room (if available) Hotel Interested in hearing more about LCU Send me info Payment Options* Pay Now Pay by Check Total number of students attending The Vine Conference* Price: $35.00 Quantity: $35 on or before March 16th & $50 on or after March 17th. Sponsors are FreeTotal $0.00 Early Registration ends on 3/17/20 at 12:00 am.