ROTC Individual Registration
Register for ROTC 2017 by filling out the information below:
Select Your Church
June 26 - July 1, 2017 - Quitman, TX
Your Contact Info
Name
Your answer
Date of Birth
Your answer
Age
Your answer
Grade Completed by Summer 2017
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 ROTC Code of Conduct and I agree to accept and abide by such while I am at ROTC. (The above mentioned form can be downloaded on the 'Registration Page')
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 ROTC. (The above mentioned forms can be downloaded on the 'Registration Page')
Your answer
Date
Your answer
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