Youth Awakening 2017 Registration


New Life Community Church

415 Mica Road Ridgeway, VA



Name ____________________________________________________________________

Male ____   or Female _____

Church attending with________________________________________________________

I am attending as:

____Youth $40 (includes T-shirt) add $10 late fee if postmarked after January 3.

___ Adult chaperone

Please limit adult chaperones to 1 per 6 youth.

There will be a charge of $15 per additional adult chaperone to cover the cost of meals and snacks.

Please select T-shirt size. It is included in the $40 registration fee.

T- Shirt size: (circle one) S M L XL 2XL 3XL

While supplies last, adults may purchase a shirt for $10 at the event.

Please choose 4 sessions that you wish to attend. Rank them1-4 with #1 being the most wanted.


____ #Blessed – following God’s will for your life

_____Face the Book- Finding answers to life’s questions in the Bible

_____Love your Selfie – Finding your self-esteem in Christ

_____Pinterest – Does your social media reflect Christ or the World?

_____Who’s in your Chat group? – Importance of Christian friends

_____Snap with Jesus - Making time for a real relationship with Jesus

Should your group need overnight accommodations, the following accommodations are available at a discounted rate.  Please call and make your own reservations and mention NLCC Youth Awakening rate. 

Hampton Inn       (276) 647-4700

Check in is 6:30 to 7:00pm Friday night!  See you there