ASP Registration 2019
High school mission trip registration
Email address *
Youth Name
Your answer
Guardian Name
Your answer
Youth Cell
Your answer
Guardian Cell
Your answer
Family address(es)
Your answer
Do you have a church affiliation? If so, where?
Your answer
Any youth dietary restrictions?
Your answer
The following medications will be provided by Christ United Methodist Church from our medical kit and will be dispensed to youth as needed. If your child requires different over the counter medication, please feel free to send it with your youth and inform your child's team leader if your child is unable to self medicate. *
Required
In the event of a medical emergency, I authorize Christ United Methodist Church and its agents to provide for my son/daughter. I understand that all over the counter medications listed above that I have checked can be administered, by an adult leader, to my child as needed.
We read through the introductory ASP information given to us and understand that we are responsible for at least $400 of payment (unless there's scholarships) and that we must attend fundraisers or send a proxy or will pay $200 extra per fundraiser missed. *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service