Ambition Conference

Registration

Registration Options*

Student ($125.00)
InterVarsity Staff ($175.00)
Ministry Partner (alumni, volunteer, pastor/church leader, intercessor, Everycampus) ($175.00)
Faculty ($175.00)
Guest ($175.00)

Contact Information

Name*

Preferred First Name*

Email*

Confirm Email*

Yes, please send me updates and opportunities related to InterVarsity’s ministry.

Phone Number*

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

May we text you at this number for event related updates, onsite emergencies, etc.?*

Mailing Address

Address*

Emergency Contact Information

Emergency Contact Name*

Emergency Contact Relationship*

Emergency Contact Phone*

Medical Insurance: Are you covered by a Medical Insurance policy?*

Demographics

Date of Birth*

Gender*

Male
Female
Prefer Not To Identify

Ethnic Identification (check all that apply):*

Black/African American
East Asian American
Hispanic/Latino American
Middle Eastern American
Native American/Alaska Native/First Nations
Native Hawaiian/Polynesian/Melanesian/Micronesian
South Asian American
Southeast Asian American (Including Filipino)
White/Caucasian American
Bi-Racial/Multi-Racial (Include any counted in the other ethnic categories)
International
Prefer Not To Identify

Additional Information

Where do you serve on staff?*

Which partnership role best describes you? (check all that apply)*

InterVarsity Volunteer
Intercessor
Church Leader/Pastor
InterVarsity Alumni
Everycampus Partner
Faculty

Individual Release/Waiver

Individual Release/Waiver | Version 10.22.2020*

I have read and agree to the terms above.

Should the PDF not display properly, you may download a copy of the Individual Release-Waiver_10.22.2020.pdf

Running Total

$0.00

Coupon Code

Would you like to donate to the scholarship fund to help students attend Ambition?

Total

$0.00

Billing Information

Name*

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Address*

Email*

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