Converge 2023 Registration Dates: Check-in: April 13th Check-out: April 16th Price: $75 for Commuters $175 for Residents Please enable JavaScript in your browser to complete this form.Student Name *Student Email *Student Phone *Parent/Guardian Name *Parent/Guardian Email *Parent/Guardian Phone *Current High School *AddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeGender *MaleFemaleWhere will you be staying? *On campusOff campusInterests *GuitarPianoDrumsBassVoiceWorship technologyOtherIf other, please specify below: *Any questions or comments?Do you have a discount code?YesNoDiscount CodeOff Campus Payment *Price: $75.00On Campus Payment *Price: $175.00PaymentPrice: $0.00Stripe Credit Card *CardName on CardSubmit
