Meridian South Stake Trek

Get Registered

Youth Participant Information

First Name *

Last Name *

Your Email *

Stake *

select

Ward *

select

Gender * FemaleMale

Age (Time of trek) *

select

School Year (2020-2021) *

select

Best # to call

Best # to text *

Parent/Guardian Information

Parent/Guardian (1)

Name *

Cell Phone/SMS *

Other Phone *

Email *

Relationship to you *

select

Parent/Guardian (2) Optional

Name *

Cell Phone/SMS *

Other Phone *

Email *

Relationship to you

select

Additional Information

Medication

Do you take any medication?

select

If Yes, Please give details *

Special Diet

Do you have a special diet?

select

If Yes, Please give details *

Allergies

Do you have any allergies?

select

If Yes, Please give details *

Physical, Mental, or Emotional Concerns

Do you have any mental, physical, emotional concerns?

select

If Yes, Please give details *

Anything Else?

Is there anything else you would like to add?

Other

Important! Please select ANY that apply: If my child has food restrictions, I’m comfortable providing food that meets their needs during their Trek experience.

Security Question and Answer

Important! You will use this information to access your registration if you need to make changes or provide additional information at a later date.

Question *

select

Answer *