Eternal Life Harvest Center
1801 Western Avenue
Knoxville, TN 37921
865.971.1988 (Phone)
865.637.0560 (Fax)
elhc@eternallifeharvest.org

ELHC Contact Directory

The Standard Youth Conference 2008
Individual Registration

Attendee's Information  
First Name:
Last Name:
Street Address:
City, State & Zip:
Phone Number: 000-000-0000
Age:
Email Address:
   
Additional Information  
Church Name:
Parent Name:
Parent Phone: 000-000-0000
Parent Email Address:
Emergency Contact:
Relation:
Phone Number: 000-000-0000
   
Will you require special accommodations (i.e. wheelchair accessibility, sign language interpreter, etc)?
   
If Yes, please specify:
 
 

NOTE: If for any reason you do not complete the online payment portion of this registration, your information will NOT be sent to Eternal Life Harvest and you will NOT be registered for this event.