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[Imago Dei] 2026 Young Adult Winter Conference

Name *

Gender *

Male

Female

Mobile Phone *

Email *

Stay over night at Church *

Yes

No

Meal selection *

Friday dinner

Saturday lunch

Saturday dinner

T-shirt Size *

S

M

L

XL

XXL

No, thank you

Please list any food allergies or concern here (Or "NA" if not applicable)

Two ways to pay *

Check to CCCJ (note: 2026 YAC)

Zelle transfer to cccjfl@gmail.com