Online Registration

Each participant (youth and adults) must also print, sign, and return to their ward Young Men/Young Women leaders the Medical Registration Form and the Parental Permission and Medical Release Form in order to attend Trek.

Registration Information

General Information

Participant's Name:
Gender:	Male Female
Physically able to hike ?? miles in one day?	Yes           No
Age (time of Trek):	-- SELECT ONE: --  12    13             14             15             16             17             18             Adult Leader
Cell #:
Best Contact Phone #:
Email:
Address:
City/State/Zip:	,
Ward:	-- SELECT ONE: --             Nyssa 1st Ward             Nyssa 2nd Ward             Owyhee Ward             Parma 1st Ward             Parma 2nd Ward             Vale 2nd Ward
May we use your photo on our website and Facebook page?	Yes           No
Father's Contact
Name:
Work #:
Cell #:
Email:
Mother's Contact
Name:
Work #:
Cell #:
Email:
Other Emergency Contact
Name:
Phone:
Notes
Is there anything else you would like us to know about your Youth?