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2023 MeckMIN Youth Summit - PAY ONLINE

CAMPER INFORMATION (THIS SECTION TO BE COMPLETED BY YOUTH PARTICIPANT)

I am excited about participating in MeckMIN's Interfaith Youth Summit!

Participant's Name:

First Name

Last Name

Participant's Signature:

Current Grade:

Faith Community / House of Faith:

Dietary Restrictions:

Email:

Verify Email

Cell Phone:

PARENT/GUARDIAN INFORMATION (THIS SECTION TO BE COMPLETED BY PARENT/GUARDIAN)

I fully support my child's participation in MeckMIN's Youth Summit, Aug 18 & 19, 2023.

Parent or Guardian's Name:

First Name

Last Name

Parent or Guardian's Signature:

Date:

(mm/dd/yyyy)

Email:

Verify Email

Phone 1:

Phone 2:

Summit Fee $100 (Pay what you can)

I am paying the $100 summit fee

Online

Other Amount (Pay what you can)

$100

$75

$50

$25

$0 - Check

I am requesting financial aid in the amount of?

I am able to pay this amount

We are glad to offer financial aid as needed. Because we will raise the financial aid money and because of the limited space in this summit, please know that by accepting financial aid, you MUST commit to participating in all two days of the camp.

Add 3% to my total amount to help cover the payment processing fees