Young Adult Winter Trip 2018 - North Carolina
Please complete this form. Take care to ensure all information is correct. We will be traveling to North Carolina from December 26th to December 31st, 2018 to aid in Hurricane Florence disaster relief. Thank you for joining us!
What is your first name? *
Your answer
What is your last name? *
Your answer
What is your email address? *
Your answer
What is your cell phone number (including area code)? *
Your answer
How old will you be as of December 26th, 2018? *
Your answer
Do you have experience driving 12-15 passenger vans?
If yes, would you be willing to drive?
Do you have any specific skills (construction or ministerial) that may help lead the group? If so, please explain.
Your answer
Who should we contact in the event of an emergency? Please include full name and phone number. *
Your answer
Medical Insurance Information: Please include provider name, Group Number, and ID Number (in that order) *
Your answer
Do you have any food allergies? If so, please list below. *
Your answer
Do you have any drug allergies? If so, please list below. *
Your answer
What is your T-shirt size? *
Is there anything else you think I should know about you to make this trip a success?
Your answer
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