National Children & Youth Conference

Please provide the following information to register for the National Children & Youth Conference. Registration does not include hotel reservations, we will provide hotel reservation information on the following page.

Event location:
Sheraton Indianapolis City Centre Hotel

Event dates:
September 20-22, 2013

* Indicates a required field.

Registrant Information:

First name: *

Last name: *

Address: *

City: *

State: *

Zip: *

Phone number: *

E-mail address: *

Department: *

Preferred name for badge: *

Affiliation: *

Are you a Department Children & Youth Chairman?: *