Facebook X (Twitter) Flocknote YouTube Instagram

Payment Link for Youth Ministry

- Payment Form for Youth Ministry Events and Program
  
  Please note, this form is for payment only and does not constitute registration for an event or program.
- This form is not accepting responses at this time.
  
  Parent Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Event/Program REQUIRED Please fill out this field.
  
  Payment for Teens
  
  Number of Teens Please fill out this field.
  
  Teen 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Payment for DYC50.0
  
  Teen 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Deposit for DYC50.0
  
  Teen 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Deposit for DYC50.0
  
  This form is for payment only. I understand I must also complete a registration form for the event/program indicated above.
  I Agree Please select this field.
  
  Total:
  
  Submit
  
  Proceed to Payment
  
  This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.