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Middle School Mission Trip Individual Registration
Register for M.S.M.T 2018 by filling out the information below:
Your Church
Your answer
Your Contact Info
Name *
Your answer
Date of Birth *
Your answer
Age *
Your answer
Grade Completed by Summer 2018 *
Gender *
Address *
Your answer
Phone *
Your answer
Email *
Your answer
T-Shirt Size *
Emergency Contact Name, Phone, and Relationship to Participant *
Your answer
Adult Information (21+)
Occupation
Your answer
Cell Phone
Your answer
Type of Vehicle at Camp and # of Seatbelts
Your answer
Your History
Any and All Medical Conditions/Allergies
Your answer
Date of Last Tetanus Shot
Your answer
List All Medications Taken at Camp
Your answer
List Any Special Dietary Needs
Your answer
List Any Family Members Attending Camp
Your answer
Have You Attended a Mission Trip Before? *
If Yes, List Years & Names of Trips
Your answer
Please Rank Your Skills in the Following Areas
Carpentry/Construction *
Never
Often
First Aid *
Never
Often
Cooking *
Never
Often
Participant Agreement
By typing my name in the box below, I acknowledge that I have read and understood the Middle School Mission Trip Code of Conduct and I agree to accept and abide by such while I am on the trip. *
Your answer
Date *
Your answer
Parent/Guardian Agreement
By typing my name in the box below, I acknowledge that I have read and understood the Press/Medical Release Form and the Code of Conduct Form and I agree to accept the terms and conditions of both for the minor whose name appears on this page. As the parent/legal gaurdian, I grant permission for the minor to participate fully in the activities of Middle School Mission Trip. *
Your answer
Date *
Your answer
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