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

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 order confirmations, updates, event reminders, and event information. Message frequency varies. Message and data rates may apply. Reply HELP for help, STOP to cancel. 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

Additional Information

Where do you serve on staff?

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

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Name

Credit CardSecure Payment

Address

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